Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.
Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York.
Neurosurgery. 2018 Mar 1;82(3):312-321. doi: 10.1093/neuros/nyx169.
Neuroendovascular intervention has become a key treatment option for acute ischemic stroke. The Sofia (6F) PLUS catheter was designed for neurovascular access for diagnostic or therapeutic interventions.
To report the first series describing use of the Sofia PLUS intermediate/distal access reperfusion catheter in the treatment of acute ischemic stroke.
In this retrospective study, 41 stroke cases were identified in which the catheter was utilized for thrombolysis/thrombectomy. Mean preprocedure National Institutes of Health Stroke Scale score was 16.5 ± 5.2 (range 4-29). Occluded vessels included the M1 segment, M2 segment, internal carotid artery terminus, cervical internal carotid artery, and basilar artery.
Successful positioning of the Sofia PLUS catheter near the occlusion site was achieved in 38 (92.7%) of 41 cases in which thrombectomy or thrombolysis was attempted using intraarterial tissue plasminogen activator, a direct aspiration first-pass technique, and/or stent retrieval. A postprocedure thrombolysis in cerebral infarction (TICI) score of 2b/3 was achieved in 37 of 41 cases. Of 15 cases where the Sofia PLUS was used for a direct aspiration first-pass technique, TICI 2b/3 was achieved in 11 (73.3%). In one case where intra-arterial tissue plasminogen activator was used as the only treatment modality, TICI 2a was achieved. No device-related or catheter-related complications were observed. The mean 7-d-postprocedure National Institutes of Health Stroke Scale score among the 39 survivors was 8.5 ± 7.3 (range 0-23).
Initial results with use of the Sofia (6F) PLUS for endovascular treatment of acute ischemic stroke have been encouraging. Experience with a larger series is warranted to further evaluate the safety and efficacy of this device and compare it with other reperfusion catheters.
神经血管介入已成为急性缺血性脑卒中的主要治疗选择。Sofia（6F）PLUS 导管专为神经血管入路的诊断或治疗干预而设计。
报告首例使用 Sofia PLUS 中间/远端接触再灌注导管治疗急性缺血性脑卒中的系列病例。
在这项回顾性研究中，确定了 41 例使用导管进行溶栓/取栓的脑卒中病例。平均术前 NIHSS 评分为 16.5±5.2（范围 4-29）。闭塞血管包括 M1 段、M2 段、颈内动脉终末段、颈内动脉、基底动脉。
在尝试使用动脉内组织型纤溶酶原激活剂、直接抽吸首过技术和/或支架取栓进行血栓切除术或溶栓治疗的 41 例病例中，成功将 Sofia PLUS 导管定位在闭塞部位附近的 38 例（92.7%）。41 例中，37 例达到术后脑梗死溶栓（TICI）评分 2b/3。在 15 例使用 Sofia PLUS 进行直接抽吸首过技术的病例中，11 例（73.3%）达到 TICI 2b/3。在仅使用动脉内组织型纤溶酶原激活剂作为唯一治疗方式的 1 例中，TICI 2a。未观察到与器械或导管相关的并发症。39 例存活者术后 7 天 NIHSS 评分平均为 8.5±7.3（范围 0-23）。
使用 Sofia（6F）PLUS 进行急性缺血性脑卒中血管内治疗的初步结果令人鼓舞。需要更大系列的经验来进一步评估该器械的安全性和有效性，并与其他再灌注导管进行比较。
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