新一代 0.071 英寸和 0.072 英寸抽吸导管的临床比较。
Clinical Comparison of New Generation 0.071-inch and 0.072-inch Aspiration Catheters.
机构信息
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; The Stroke Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; The Stroke Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
出版信息
World Neurosurg. 2019 Oct;130:e463-e466. doi: 10.1016/j.wneu.2019.06.120. Epub 2019 Jun 25.
INTRODUCTION
Three new 0.071-inch and 0.072-inch aspiration catheters have been introduced for stroke thrombectomy. Their comparative efficacy has not been clinically evaluated.
METHODS
We reviewed a prospectively maintained thrombectomy database for cases using 1 of these 3 catheters for proximal large vessel occlusion from September 2018 to February 2019. Clinical and angiographic information was extracted.
RESULTS
Of 145 thrombectomies performed over the time period, 49 utilized 1 of the 3 new large-bore catheters (React 71, n = 21; Vecta 71, n = 19; Jet 7, n = 9) on the first pass. Mean patient age was 73 years (SD: 15). Mean presenting National Institute of Health Stroke Scale score was 19 (SD: 6, range: 5-33). Clot location was middle cerebral artery first segment in 59% of cases, internal carotid artery in 31%, and basilar in 10%. With or without a stentriever, clot access with the initially selected aspiration catheter was achieved in 47 of 49 (96%) cases. Excluding empiric stentriever usage, the aspiration catheter could be delivered to the clot without needing a stentriever in 87% of cases: 100% with React 71, 93% with Vecta 71, and 43% with Jet 7 (P = 0.002). Final Thrombolysis in Cerebral Infarction score 2b/3 was achieved in 92% of cases overall: 95% with React 71, 89% with Jet 7, and 89% with Vecta 71. Median procedure time was 28 minutes; mean total number of passes was 2.4 (SD: 1.6) with 39% of cases being single-pass cases. These rates did not significantly differ between aspiration catheters.
CONCLUSIONS
In comparing the newest large bore aspiration catheters, similar angiographic efficacy is achieved.
简介
三种新的 0.071 英寸和 0.072 英寸抽吸导管已被引入用于卒中取栓。它们的疗效比较尚未在临床上进行评估。
方法
我们回顾了 2018 年 9 月至 2019 年 2 月期间使用这 3 种导管之一进行近端大血管闭塞取栓的前瞻性维护的血栓切除术数据库。提取了临床和血管造影信息。
结果
在这段时间内进行了 145 例血栓切除术，其中 49 例在首次尝试时使用了 3 种新的大口径导管中的 1 种（React 71，n=21；Vecta 71，n=19；Jet 7，n=9）。患者平均年龄为 73 岁（标准差：15）。平均发病 NIHSS 评分为 19（标准差：6，范围：5-33）。血栓位置在 59%的病例中为大脑中动脉第一段，31%为颈内动脉，10%为基底动脉。无论是否使用支架取栓器，最初选择的抽吸导管均能到达 49 例中的 47 例（96%）血栓部位。排除经验性支架取栓器的使用，在 87%的病例中，抽吸导管可以不经支架取栓器直接送达血栓部位：React 71 为 100%，Vecta 71 为 93%，Jet 7 为 43%（P=0.002）。总体上，92%的病例达到最终脑梗死溶栓评分 2b/3：React 71 为 95%，Jet 7 为 89%，Vecta 71 为 89%。中位手术时间为 28 分钟；平均导管总通过次数为 2.4（标准差：1.6），其中 39%的病例为单次通过。这些比率在抽吸导管之间没有显著差异。
结论
在比较最新的大口径抽吸导管时，其血管造影效果相似。
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