Wenger K J, Berkefeld J, Wagner M
Department of Neuroradiology, Johann Wolfgang Goethe University, Schleusenweg 2-16, Haus 95, 60528, Frankfurt am Main, Germany,
Clin Neuroradiol. 2014 Sep;24(3):251-4. doi: 10.1007/s00062-013-0246-6. Epub 2013 Aug 15.
The purpose of this study was to create virtual 3D views of the interaction between contrast-enhanced thrombi and three different types of stent retrievers.
Artificial thrombi with and without contrast agent were created and introduced into a silicone tube with saline solution. The stent retrievers (Aperio (A), Solitaire FR (B), Revive (C)) were released around the thrombi. For each retriever, two sets (0 min, 5 min) of flat panel computed tomography (CT) data were acquired on a Siemens Axiom Artis Zee biplane angiography system and reconstructed using syngo InSpace 3D software.
The filaments of all three stent retrievers were displaced by the thrombus immediately after deployment. Another study series after 5 min showed further expansion of the stents into the thrombus. A tends to appose best around obstacles. A and B allow cushion-like bulging of clot material into the stent lumen. C showed only moderate curvilinear bulging and a minor degree of interaction in between stent filaments and thrombus.
Flexible design allows better apposition of the device to the surface of the thrombus. A relatively strong longitudinal structure combined with large gaps in between the stent filaments seems to favor migration into the clot. The main capture mechanism seems to be engagement of the clot between the crossings of stent struts.
本研究的目的是创建增强造影剂血栓与三种不同类型支架取栓器之间相互作用的虚拟三维视图。
制作含和不含造影剂的人工血栓，并将其放入装有盐溶液的硅胶管中。将支架取栓器（Aperio（A）、Solitaire FR（B）、Revive（C））释放在血栓周围。对于每个取栓器，在西门子Axiom Artis Zee双平面血管造影系统上采集两组（0分钟、5分钟）平板计算机断层扫描（CT）数据，并使用syngo InSpace 3D软件进行重建。
所有三种支架取栓器的细丝在展开后立即被血栓移位。5分钟后的另一组研究显示支架进一步向血栓内扩展。A在障碍物周围的贴合效果最佳。A和B允许凝块物质呈垫状凸入支架腔内。C仅显示中度曲线状凸起，且支架细丝与血栓之间的相互作用程度较小。
灵活的设计使设备能更好地贴合血栓表面。相对较强的纵向结构与支架细丝之间的大间隙似乎有利于向凝块内迁移。主要的捕获机制似乎是凝块在支架支柱交叉处的嵌入。
