Purpose: The purpose of this study was to evaluate the safety and efficacy of mechanical thrombectomy with a direct aspiration first-pass technique (ADAPT) using large-bore catheters in patients with acute ischemic stroke due to large vessel occlusion (LVO) in a hospital in Vietnam. Methods: This was a retrospective review of patients with acute ischemic stroke due to LVO who were diagnosed and underwent mechanical thrombectomy using ADAPT with large-bore catheters at Bach Mai Hospital from January 2017 to June 2018. Results: Seventy-three patients (47.9% female; age: 61.29 ± 14.49 years) met study criteria. The average procedure duration was 45.09 ± 38.26 min. Successful recanalization post-ADAPT (thrombolysis in cerebral infarction 2b-3) was achieved in 72.6% (53/73) of patients. Good functional outcome (Modified Rankin Scale 0–2) at 3 months was achieved in 50.7% (37/73), with poor functional outcome in 24.7% (18/73). The 90-day mortality rate was 24.7% (18/73). The hemorrhagic transformation rate was 31.6%, in which 19.2% were symptomatic. Vessel perforation occurred in 5.5% (4/73) of patients but in all cases was associated with the guidewire and not the reperfusion catheter. Vessel dissection occurred in 1.4% (1/73) and vasospasm in 5.5% (4/73) of patients. Conclusion: Mechanical thrombectomy using ADAPT with large-bore catheters for acute ischemic stroke due to LVO is a method that yielded good results in recanalization and clinical recovery in a Vietnamese patient population.

Background: Although men have a higher rate of stroke than women, it is not clear whether women have a worse outcome after adjusting for confounders such as vascular risk factors, age, stroke severity, and reperfusion therapy. We evaluated sex differences on 90-day functional outcomes after stroke in a multicenter study in Vietnam. Methods: We recruited patients presenting with ischemic or hemorrhagic stroke at 10 stroke centers in Vietnam for a period of 1 month from August 1, 2022, to August 31, 2022. We reviewed the patient’s clinical demographics, time from symptom onset to hospital admission, stroke classification, stroke subtype, stroke severity, characteristics of reperfusion therapy, and 90-day clinical outcome. We compared functional outcomes and predisposing factors at day 90 between men and women after an ischemic and hemorrhagic stroke. Poor outcome was defined as mRS 3-6. Results: There were 2,300 stroke patients included. Men accounted for 61.3% (1,410) of participants. Compared with men, women were older (67.7±13.9 vs. 63.7±13.3, P<0.001), had a higher rate of diabetes mellitus (21.1% vs.15.3%, P<0.001), a lower rate of smoking (1.0 % vs. 23.6%, P<0.001), and a lower BMI (21.4 ± 2.70 vs. 22.0 ± 2.72, P<0.001). There was a higher rate of ICH in men (21.3% vs.15.6%, P=0.001), whereas the rate of subarachnoid hemorrhage was higher in women (6.2% vs.3.0%, P<0.001). For ischemic stroke, door-to-needle time (36.9±17.6 vs. 47.8±35.2 minutes, P=0.04) and door-to-recanalization time (113.6±51.1 vs.134.2±48.2, p=0.03) were shorter in women. There was no difference in 90-day functional outcomes between sexes. Factors associated with poor outcomes included age ≥ 50 years (adjusted OR, aOR 1.75; 95% CI, 1.16 to 2.66), history of stroke (aOR 1.50; 95% CI, 1.15 to 1.96), large artery atherosclerosis (aOR 5.19; 95% CI, 3.90 to 6.90), and cardioembolism (aOR 3.21; 95% CI, 1.68 to 6.16). Factors associated with mortality in patients with acute ischemic stroke included a history of coronary artery disease (aOR 3.04; 95% CI, 1.03 to 8.92), large artery atherosclerosis (aOR 3.37; 95% CI, 2.11 to 5.37), and cardioembolism (aOR 3.15; 95%CI, 1.20 to 8.27). Conclusion: There were no sex differences in the clinical outcome of stroke and ischemic stroke in this prospective cohort of hospitalized Vietnamese patients

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