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使用新型 0.071 英寸抽吸导管直接抽吸血栓形成术的初步经验。

Initial Experience in Direct Aspiration Thrombectomy Using a Novel 0.071-Inch Aspiration Catheter.

机构信息

Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA.

Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA.

出版信息

World Neurosurg. 2019 Jun;126:272-275. doi: 10.1016/j.wneu.2019.03.055. Epub 2019 Mar 14.

Abstract

INTRODUCTION

A Direct Aspiration First Pass Technique is one of the most widely used techniques in mechanical thrombectomy. Aspiration catheter size plays a major role in the success of this technique. The AXS Vecta (Stryker Neurovascular, Fremont, California, USA) aspiration catheter is the first approved 0.071-inch catheter for mechanical thrombectomy. Here, we report our initial experience with direct aspiration thrombectomy using the AXS Vecta aspiration catheter.

METHODS

We reviewed the prospectively collected database of all consecutive patients with stroke who underwent thrombectomy using A Direct Aspiration First Pass Technique with the AXS Vecta aspiration catheter at our institution between September 26 and October 12, 2018.

RESULTS

A total of 10 thrombectomy procedures were performed. Of those, 3 patients had M1 occlusion, 6 patients had M2 occlusion, and 1 patient had cervical carotid + M1 tandem occlusion. Modified Thrombolysis in Cerebral Ischemia grade 2b or greater revascularization was obtained in 9 of 10 patients. Median groin-to-reperfusion time was 29.5 (interquartile range 14.25-53.25) minutes. An intermediate catheter (3 Max) was used in all cases. No procedural complications or vascular injury were identified. The AXS Vecta catheter demonstrated excellent tractability and navigability in all cases except 1 case with severe narrowing of M1 segment secondary to atherosclerosis.

CONCLUSIONS

In this early experience with the new AXS Vecta aspiration catheter, the catheter was safely navigated to the target vessel even at the level of M2 segment.

摘要

简介

直接抽吸首过技术是机械血栓切除术最广泛应用的技术之一。抽吸导管的大小在该技术的成功中起着重要作用。AXS Vecta(Stryker Neurovascular,加利福尼亚州弗里蒙特,美国)抽吸导管是第一个获得批准的用于机械血栓切除术的 0.071 英寸导管。在这里,我们报告了我们在机构中使用 AXS Vecta 抽吸导管进行直接抽吸血栓切除术的初步经验。

方法

我们回顾了 2018 年 9 月 26 日至 10 月 12 日期间,所有在我们机构接受 A 直接抽吸首过技术联合 AXS Vecta 抽吸导管进行血栓切除术的连续患者的前瞻性收集数据库。

结果

共进行了 10 次血栓切除术。其中,3 例患者为 M1 闭塞,6 例患者为 M2 闭塞,1 例患者为颈内颈动脉+M1 串联闭塞。9/10 例患者获得改良脑梗死溶栓分级 2b 或更高的再通。股动脉至再灌注时间中位数为 29.5(四分位距 14.25-53.25)分钟。所有病例均使用中间导管(3 Max)。未发现程序并发症或血管损伤。除 1 例因动脉粥样硬化导致 M1 段严重狭窄外,AXS Vecta 导管在所有病例中均表现出良好的可操作性和可导航性。

结论

在使用新的 AXS Vecta 抽吸导管的早期经验中,即使在 M2 段,导管也可以安全地导航至靶血管。

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