From the Department of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., M.W.), RWTH Aachen University Hospital, Aachen, Germany
From the Department of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., M.W.), RWTH Aachen University Hospital, Aachen, Germany.
AJNR Am J Neuroradiol. 2018 May;39(5):905-909. doi: 10.3174/ajnr.A5605. Epub 2018 Apr 12.
Blood flow should be interrupted during mechanical thrombectomy to prevent embolization of clot fragments. The purpose of our study was to provide a handy overview of the most common aspiration devices and to quantify their flow characteristics.
We assessed volumetric flow rates generated by a 60-mL VacLok vacuum pressure syringe, a Pump MAX aspiration pump, and a Dominant Flex suction pump connected to the following: 1) an 8F long sheath, 2) an 8F balloon-guide catheter, 3) an ACE 64 distal aspiration catheter, and 4) an AXS Catalyst 6 Distal Access Catheter. We used a water/glycerol solution, which was kept at a constant temperature of 20°C (viscosity, 3.7 mPa · s).
Aspiration with the syringe and the Dominant Flex suction pump achieved the highest flows, whereas aspiration with the Pump MAX was significantly lower ( < .001). Resistors in the aspiration system (tubing, connectors, and so forth) restricted flows, especially when the resistance of the catheter was small (due to its large diameter) and the connected resistors became the predominant resistance ( < .001). The syringe achieved an average vacuum pressure of -90 kPa, and the resulting flow was constant during almost the entire procedure of filling the syringe.
Sixty-milliliter VacLok vacuum pressure syringes and the Dominant Flex suction pump achieved high and constant flows likely sufficient to reverse blood flow during thrombectomy with an 8F sheath or balloon-guide catheter in the ICA and modern distal aspiration catheters in the MCA. The Pump MAX aspiration pump is dedicated for use with distal aspiration catheters and is unlikely to reverse blood flow in the ICA and MCA without balloon protection.
在机械血栓切除术中应中断血流以防止血栓碎片栓塞。我们的研究目的是提供最常见抽吸装置的概述，并对其流量特性进行量化。
我们评估了 60 毫升 VacLok 真空压力注射器、Pump MAX 抽吸泵和 Dominant Flex 抽吸泵在以下情况下产生的容积流速：1）8F 长鞘，2）8F 球囊引导导管，3）ACE 64 远端抽吸导管，和 4）AXS Catalyst 6 远端接入导管。我们使用水/甘油溶液，保持在 20°C 的恒定温度（粘度为 3.7 mPa·s）。
注射器和 Dominant Flex 抽吸泵的抽吸效果达到最高流速，而 Pump MAX 的抽吸效果明显较低（<0.001）。抽吸系统中的阻力（管、连接器等）限制了流量，尤其是当导管的阻力较小（由于其直径较大）并且连接的阻力成为主要阻力时（<0.001）。注射器达到了平均 -90 kPa 的真空压力，并且在几乎整个注射器填充过程中，流量保持恒定。
60 毫升 VacLok 真空压力注射器和 Dominant Flex 抽吸泵实现了高且恒定的流量，足以逆转 ICA 中 8F 鞘或球囊引导导管和 MCA 中现代远端抽吸导管进行血栓切除术期间的血流。Pump MAX 抽吸泵专门用于与远端抽吸导管一起使用，如果没有球囊保护，可能无法逆转 ICA 和 MCA 中的血流。
