{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:35:25Z","timestamp":1784097325354,"version":"3.55.0"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:00:00Z","timestamp":1679875200000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003Endovascular therapy has become the mainstay of treatment of acute ischemic stroke (AIS) due to large vessel occlusion. A direct aspiration first-pass technique (ADAPT) using large bore aspiration catheters has been introduced as a rapid, simple method for achieving good revascularization and good clinical outcomes. The aim of this study was to assess the safety and efficacy of ADAPT in the treatment of AIS due to large-vessel occlusion in the Nepali patient population.<\/jats:p><jats:p>\n          Materials and Methods\u2003Retrospective data were collected for all consecutive patients treated for AIS with ADAPT from March 2019 through January 2021 at two hospitals. Outcomes were successful revascularization (modified thrombolysis in cerebral infarction score of 2b-3), time to revascularization, procedural complications, and good clinical outcome (modified Rankin Scale score of 0 to 2) and mortality at 90 days.<\/jats:p><jats:p>\n          Statistical Analysis\u2003Retrospective data were collected and descriptive statistics were calculated.<\/jats:p><jats:p>\n          Results\u2003Sixty-eight patients treated for AIS with ADAPT were included. The median National Institutes of Health Stroke Scale score at presentation was 13 (IQR 10\u201313.25). The median time from arterial puncture to revascularization was 40\u2009minutes (IQR 30\u201345). Successful revascularization was achieved in 54 patients (79.4%). No cases of symptomatic intracranial hemorrhage occurred. At 90-day follow-up, good clinical outcome was achieved in 57 patients (83.8%), and 4 patients died (5.9%).<\/jats:p><jats:p>\n          Conclusion\u2003A direct aspiration first pass technique appears to be a fast, simple, safe, and effective method for the management of AIS in the Nepali patient population.<\/jats:p>","DOI":"10.1055\/s-0043-1761233","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T23:03:26Z","timestamp":1679958206000},"page":"075-079","source":"Crossref","is-referenced-by-count":2,"title":["Initial Results of a Direct Aspiration First-Pass Technique to Treat Acute Ischemic Stroke Patients in Nepal"],"prefix":"10.1055","volume":"18","author":[{"given":"Subash","family":"Phuyal","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging and Interventional Neuroradiology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Kathmandu, Nepal"},{"name":"Department of Neuroradiology, Grande International Hospital, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raju","family":"Paudel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Grande International Hospital, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritesh","family":"Lamsal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lekhjung","family":"Thapa","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Neuro Centre, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anzil Mani Singh","family":"Maharjan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bikram Prasad","family":"Gajurel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,3,27]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S1474-4422(19)30034-1","article-title":"Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"18","author":"GBD 2016 Stroke Collaborators","year":"2019","journal-title":"Lancet Neurol"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1111\/j.1747-4949.2012.00799.x","article-title":"Burden of stroke in Nepal","volume":"7","author":"M M Shaik","year":"2012","journal-title":"Int J 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An Egyptian center experience","volume":"14","author":"W S Bahnasy","year":"2019","journal-title":"eNeurologicalSci"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.09.036","article-title":"Response to symptoms and prehospital delay in stroke patients. Is it time to reconsider stroke awareness campaigns?","volume":"27","author":"R Garc\u00eda Ruiz","year":"2018","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1016\/S0140-6736(19)30297-1","article-title":"Aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion (COMPASS): a multicentre, randomised, open label, blinded outcome, non-inferiority trial","volume":"393","author":"A S Turk III","year":"2019","journal-title":"Lancet"},{"issue":"09","key":"ref17","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1136\/neurintsurg-2014-011282","article-title":"Comparison of endovascular treatment approaches for acute ischemic stroke: cost effectiveness, technical success, and clinical outcomes","volume":"7","author":"A S Turk","year":"2015","journal-title":"J Neurointerv Surg"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1161\/01.STR.0000196957.55928.ab","article-title":"Time is brain\u2013quantified","volume":"37","author":"J L Saver","year":"2006","journal-title":"Stroke"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"317","DOI":"10.5853\/jos.2020.01767","article-title":"Mothership versus drip-and-ship model for mechanical thrombectomy in acute stroke: A systematic review and meta-analysis for clinical and radiological outcomes","volume":"22","author":"M Romoli","year":"2020","journal-title":"J Stroke"},{"issue":"07","key":"ref20","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1161\/01.STR.0000170622.07210.b4","article-title":"Recommendations for comprehensive stroke centers: a consensus statement from the Brain Attack Coalition","volume":"36","author":"M J Alberts","year":"2005","journal-title":"Stroke"},{"issue":"09","key":"ref21","doi-asserted-by":"crossref","first-page":"2651","DOI":"10.1161\/STROKEAHA.111.615336","article-title":"Revised and updated recommendations for the establishment of primary stroke centers: a summary statement from the brain attack coalition","volume":"42","author":"M J Alberts","year":"2011","journal-title":"Stroke"}],"container-title":["Asian Journal of Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1761233.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T00:47:50Z","timestamp":1681260470000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1761233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":21,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2023,4,11]]},"published-print":{"date-parts":[[2023,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1761233","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1793-5482","2248-9614"],"issn-type":[{"value":"1793-5482","type":"print"},{"value":"2248-9614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}