ĐÁNH GIÁ HIỆU QUẢ VÀ ĐỘ AN TOÀN CỦA PHƯƠNG PHÁP HÚT HUYẾT KHỐI TRỰC TIẾP BẰNG ỐNG THÔNG TRONG ĐIỀU TRỊ ĐỘT QUỴ CẤP TẮC ĐỘNG MẠCH NÃO GIỮA ĐOẠN M1

Abstract

Background: Occlusion of the M1 segment of the middle cerebral artery (MCA) is a common cause of large-vessel ischemic stroke, associated with high disability and mortality. Evidence from routine practice on the direct aspiration strategy (ADAPT – A Direct Aspiration First Pass Technique) remains limited. This study aimed to evaluate the efficacy and safety of aspiration thrombectomy in patients with acute M1 occlusion. Materials and methods: A prospective study was conducted at Cho Ray Hospital from January 2023 to June 2025, including patients with acute ischemic stroke due to isolated M1 MCA occlusion who underwent endovascular thrombectomy. Main variables included successful reperfusion (mTICI), functional outcome at 90 days (mRS), intracranial hemorrhage, mortality, and procedural complications. Results: 61 patients, mean age 65 years. Successful reperfusion (mTICI ≥2b) was achieved in 71.1% after the first pass and 96.7% overall. Functional independence (mRS 0–2) at 90 days was 54.1%, with a mortality rate of 18%. Median puncture-to-reperfusion time was 20 minutes. Symptomatic intracranial hemorrhage occurred in 13.1%. Procedural complications included dissection, vasospasm in 4.9%, new distal embolization in 3.3%, and no vessel perforation. Conclusion: Aspiration thrombectomy for acute M1 MCA occlusion achieved a high reperfusion rate, rapid procedural times, and favorable functional outcomes with a low rate of complications.