Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yishan Road, Shanghai, 200233, China.
Department of Neurology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yishan Road, Shanghai, 200233, China.
Eur J Radiol. 2021 Jun;139:109723. doi: 10.1016/j.ejrad.2021.109723. Epub 2021 Apr 14.
To compare the extent of arterial wall damage when SR and CA were used for treatment of AIS models to evaluate their efficacy and safety.
A thrombin-induced thrombus was pre-injected into the right distal external carotid-maxillary artery (ECMA) in 12 dogs to create an acute thrombus occlusion model and were randomly divided into the SR group (n = 6; received SR treatment) and CA group (n = 6; received CA treatment). Device safety was also assessed by five passages through the normal left ECMA using each device. Device manipulation-related damage to arterial walls, final flow restoration, recanalization time and complications were recorded.
Sixteen retriever and 10 aspiration attempts were performed in the SR and CA groups. Reperfusion time was significantly reduced in the CA group (17.83 ± 1.96 vs. 28.33 ± 3.26 in the SR group; P = 0.02). Stent retriever thrombectomy resulted in an increased risk of endothelium denudation (1.17 ± 0.24 in SR group vs. 0.42 ± 0.15 in CA group; P = 0.01) and reduced frequency of vessel vasospasm (0.67 ± 0.14 in SR group vs. 0.25 ± 0.13 in CA group; P = 0.04). Injury score and thrombus deposition were similar between the two groups (P > 0.05). TICI 2b/3 flow restoration values of the right ECMA were 100 % in both groups. Device-related complications, including dissection (P = 0.21), side branch influence (P = 0.24), and distal thromboembolism (P = 1.00), did not differ between the two groups.
Both devices had similar efficacy and caused minimal arterial wall damage in our dog models. SR was more likely to cause endothelium denudation, while CA had a greater risk of vasospasm.
比较 SR 和 CA 治疗 AIS 模型时动脉壁损伤的程度，以评估其疗效和安全性。
将 12 只犬的右侧颈外动脉-上颌动脉（ECMA）远端预先注射凝血酶以建立急性血栓闭塞模型，并随机分为 SR 组（n=6；接受 SR 治疗）和 CA 组（n=6；接受 CA 治疗）。还通过两种设备各通过正常左侧 ECMA 五次来评估设备安全性。记录设备操作相关的动脉壁损伤、最终血流恢复、再通时间和并发症。
SR 和 CA 组分别进行了 16 次取栓和 10 次抽吸尝试。CA 组再灌注时间明显缩短（SR 组 17.83±1.96 秒，CA 组 28.33±3.26 秒；P=0.02）。支架取栓术增加了血管内膜剥脱的风险（SR 组 1.17±0.24，CA 组 0.42±0.15；P=0.01），降低了血管痉挛的频率（SR 组 0.67±0.14，CA 组 0.25±0.13；P=0.04）。两组间损伤评分和血栓沉积相似（P＞0.05）。两组右侧 ECMA 的 TICI 2b/3 血流恢复值均为 100%。两组均未发生与器械相关的并发症，包括夹层（P=0.21）、侧支影响（P=0.24）和远端血栓栓塞（P=1.00）。
两种设备在我们的犬模型中均具有相似的疗效，对动脉壁的损伤最小。SR 更可能导致血管内膜剥脱，而 CA 更可能导致血管痉挛。
