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新型装置机械取栓术:ANA 取栓装置的初步临床经验。

Mechanical thrombectomy with a novel device: initial clinical experience with the ANA thrombectomy device.

机构信息

Interventional Neuroradiology Section, Department of Radiology, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: https://twitter.com/atomasell.

Interventional Neuroradiology Section, Department of Radiology, Vall d'Hebron University Hospital, Barcelona, Spain.

出版信息

J Neuroradiol. 2022 Jun;49(4):324-328. doi: 10.1016/j.neurad.2020.11.003. Epub 2020 Dec 16.

Abstract

INTRODUCTION

The ANA™ (Anaconda Biomed) thrombectomy system is a novel stroke thrombectomy device comprising a self-expanding funnel designed to reduce clot fragmentation by locally restricting flow while becoming as wide as the lodging artery. Once deployed, ANA allows distal aspiration in combination with a stentretriever (SR) to mobilize the clot into the funnel where it remains copped during extraction. We investigate safety and efficacy of ANA™ in a first-in-man study.

METHODS

Prospective data was collected on 35 consecutive patients treated as first line with ANA™ at a single centre. Outcome measures included per-pass reperfusion scores, symptomatic intracerebral hemorrhage (sICH), NIHSS at day 5, and mRS at 90 days.

RESULTS

Median NIHSS was 12(9-18). Sites of primary occlusion were: 5 ICA, 15 M1-MCA, 15 M2-MCA. Primary performance endpoint, mTICI 2b-3 within 3 passes without rescue therapy was achieved in 91.4% (n = 32) of patients; rate of complete recanalization (mTICI 2c-3) was 65.7%. First pass complete recanalization rate was 42.9%, and median number of ANA passes 1(IQR: 1-2). In 17.1% (n = 6) rescue treatment was used; median number of rescue passes was 2(1-7), leading to a final mTICI2b-3rate of 94.3% (n = 33). There were no device related serious adverse events, and rate of sICH was 5.7% (n = 2). At 5 days median NIHSS was 1 (IQR 1-6) and 90 days mRS 0-2 was achieved in 60% of patients.

CONCLUSIONS

In this initial clinical experience, the ANA™ device achieved a high rate of complete recanalization with a good safety profile and favourable 90 days clinical outcomes.

摘要

简介

ANA™(Anaconda Biomed)血栓切除术系统是一种新型的卒中取栓装置,由一个自膨式漏斗组成,旨在通过局部限制血流来减少血栓碎片形成,同时使漏斗与嵌入动脉等宽。一旦部署,ANA 允许在远端进行抽吸,并与支架取栓器(SR)联合使用,将血栓移动到漏斗中,在提取过程中保持包裹。我们在一项首例人体研究中调查了 ANA™ 的安全性和疗效。

方法

在一家单中心对 35 例连续接受 ANA™ 一线治疗的患者进行前瞻性数据收集。观察指标包括单次通过再灌注评分、症状性颅内出血(sICH)、第 5 天 NIHSS 和 90 天 mRS。

结果

中位 NIHSS 为 12(9-18)。主要闭塞部位为:5 例颈内动脉,15 例大脑中动脉 M1-MCA,15 例大脑中动脉 M2-MCA。主要性能终点为在 3 次通过内无挽救性治疗达到 mTICI 2b-3 的患者比例为 91.4%(n=32);完全再通率(mTICI 2c-3)为 65.7%。初次通过完全再通率为 42.9%,ANA 通过次数中位数为 1(IQR:1-2)。17.1%(n=6)患者使用了挽救性治疗;挽救性治疗通过次数中位数为 2(1-7),最终 mTICI2b-3 率为 94.3%(n=33)。无器械相关严重不良事件,sICH 发生率为 5.7%(n=2)。第 5 天中位 NIHSS 为 1(IQR 1-6),90 天 mRS 0-2 的患者比例为 60%。

结论

在这一初步临床经验中,ANA™ 装置实现了较高的完全再通率,具有良好的安全性和良好的 90 天临床结局。

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