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新型抽吸导管在急性脑卒中取栓中的应用

Novel aspiration catheter design for acute stroke thrombectomy.

机构信息

North Memorial Medical Center, Robbinsdale, Minnesota, USA.

Mayo Clinic, Rochester, Minnesota, USA.

出版信息

J Neurointerv Surg. 2019 Feb;11(2):190-195. doi: 10.1136/neurintsurg-2017-013702. Epub 2018 Jul 30.

Abstract

BACKGROUND

Navigable, large diameter aspiration catheters demonstrate markedly improved recanalization rates over smaller lumen devices in suction embolectomy. We evaluated the performance of a novel aspiration catheter system designed to maximize lumen size, and compare it to other commercially available aspiration catheters.

METHODS

The 6F RQ aspiration catheter system comprises a proximal pusher wire of 117 cm length connected to a distal catheter of 25 cm length. When placed through standard guide catheters and into the cerebral circulation, the proximal catheter makes a tight seal between its outer surface and the guide catheter's inner surface. During aspiration, in vitro flow rates and tip suction force under gentle retraction were compared among 10 commercially available aspiration catheters and the RQ system.

RESULTS

The RQ 6F, 5F, 4F, and 3F catheters achieved flow rates at least 21.9%, 24.7%, 61.9%, and 244.7% greater than the other catheters tested respectively and the RQ 6F produced a 140.2% higher tip force than a catheter of similar size. Fluid flow rate in the RQ 6F increased on retraction into the guide catheter, delivering a 58.2% increase from fully extended to fully retracted.

CONCLUSION

The RQ design demonstrates a substantial increase in aspirated flow rate and suction force due to an increased effective diameter than standard tubular catheter designs tested. The prominent increase in the aspiration parameters measured in vitro supports the potential for improved clinical results during stroke thrombectomy procedures.

摘要

背景

在抽吸血栓切除术方面,与较小管腔的器械相比,可导航的大直径抽吸导管显示出明显更高的再通率。我们评估了一种新型抽吸导管系统的性能,该系统旨在最大限度地增加管腔尺寸,并将其与其他市售的抽吸导管进行比较。

方法

6F RQ 抽吸导管系统由 117cm 长的近端推送线连接至 25cm 长的远端导管组成。当通过标准导引导管进入大脑循环时,近端导管的外表面与导引导管的内表面之间形成紧密密封。在体外,比较了 10 种市售抽吸导管和 RQ 系统在温和回缩时的流速和尖端抽吸力。

结果

RQ 6F、5F、4F 和 3F 导管的流速分别比其他测试导管至少高出 21.9%、24.7%、61.9%和 244.7%,而 RQ 6F 的尖端力比类似尺寸的导管高出 140.2%。RQ 6F 导管在回缩到导引导管时的流体流速增加,从完全伸出到完全缩回时增加了 58.2%。

结论

与测试的标准管状导管设计相比,RQ 设计由于有效直径的增加,显示出抽吸流速和吸力的大幅增加。在体外测量的抽吸参数明显增加,支持在卒中取栓手术中可能获得更好的临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7185/6582808/2475b4dfcb50/neurintsurg-2017-013702f01.jpg

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