Department of Radiology, Maastricht University Medical Center + (MUMC +), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
Department of Neurology, Maastricht University Medical Center + (MUMC +), Maastricht, The Netherlands.
Cardiovasc Intervent Radiol. 2019 Dec;42(12):1795-1799. doi: 10.1007/s00270-019-02280-z. Epub 2019 Jul 2.
We describe the initial results of the Syphontrack Super Distal Access (SDA) catheter (InNeuroco Inc., Sunrise, Fl, USA) used for endovascular treatment of patients with acute ischemic stroke of the anterior circulation.
A retrospective review of prospectively collected data from June 2017 to May 2018 in Maastricht University Medical Center plus (MUMC +) with direct distal aspiration or a combination of distal aspiration with stent retriever thrombectomy was performed. Primary outcome measurements were accessibility and reperfusion grade (eTICI). Secondary outcome measurements were early neurologic recovery (a decrease of four or more points on the NIHSS), symptomatic intracranial hemorrhage (sICH) within 24 h and mRS score at 3 months.
The first 50 patients in whom the SDA catheter was used are included. Direct distal aspiration was performed in 33/50 (66%). In 29/33 (88%), distal position in contact with the clot was achieved of which 15 (52%) were successful (eTICI 2b or higher) after first attempt. Total successful reperfusion rate was 23/50 (46%) after first pass. Final successful reperfusion, after multiple attempts, was reached in 48/50 (96%). Early neurologic recovery was seen in 21/50 (42%), and functional independence (mRS score of 0-2) at 3 months was achieved in 17/50 (35%). sICH occurred in 4/50 (8%) within 24 h post-procedural.
In our clinical practice, endovascular treatment of ischemic stroke with the SDA catheter had similar technical and clinical results as reported in the literature.
我们描述了 Syphontrack 超级远端通路(SDA)导管(InNeuroco Inc.,美国佛罗里达州日出市)在血管内治疗前循环急性缺血性卒中患者中的初步结果。
对 2017 年 6 月至 2018 年 5 月在马斯特里赫特大学医学中心(MUMC)前瞻性收集的数据进行回顾性分析,采用直接远端抽吸或远端抽吸联合支架取栓术。主要结局测量指标为可及性和再灌注等级(eTICI)。次要结局测量指标为早期神经功能恢复(NIHSS 评分降低 4 分或更多)、24 小时内症状性颅内出血(sICH)和 3 个月时 mRS 评分。
纳入了 50 例首次使用 SDA 导管的患者。33/50(66%)例患者进行了直接远端抽吸。在 29/33 例(88%)患者中,导管远端接触到血栓,其中 15 例(52%)在首次尝试后获得成功(eTICI 2b 或更高)。首次通过后,总再通率为 23/50(46%)。经过多次尝试,最终达到 48/50(96%)成功再通。50 例患者中有 21 例(42%)出现早期神经功能恢复,3 个月时达到功能独立性(mRS 评分 0-2)的有 17 例(35%)。术后 24 小时内发生 sICH 4 例(8%)。
在我们的临床实践中,使用 SDA 导管进行缺血性卒中的血管内治疗与文献报道的技术和临床结果相似。