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单中心应用 Scepter Mini 球囊导管的早期临床经验。

Single institution early clinical experience with the Scepter Mini balloon catheter.

机构信息

Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, USA.

Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, USA.

出版信息

Neuroradiol J. 2021 Dec;34(6):562-567. doi: 10.1177/19714009211013495. Epub 2021 May 20.

Abstract

BACKGROUND

The use of liquid embolic agents in the endovascular treatment of dural arteriovenous (dAVFs) fistulas and brain arteriovenous malformations (AVMs) has become common practice. The use of dual lumen balloon microcatheters has greatly improved the efficacy of liquid embolization. The purpose of this series is to discuss our early experience with the Scepter Mini dual lumen balloon microcatheter.

METHODS

A retrospective chart review was performed of all patients who underwent embolization with the Scepter Mini dual lumen balloon at a single institution. Technical details and procedural complications were recorded for each case.

RESULTS

In total, 10 Scepter Mini dual lumen balloon microcatheters were used in nine patients. All patients except two were treated for AVMs. Technical success was achieved in all but one case where one balloon had to be discarded due to precipitation of the tantalum powder. Average vessel diameter where the balloon was inflated was 1.1 mm (0.8-2.4 mm). It provided flow arrest in 100% of cases with no cases of reflux of embolic material. Balloon "jump back" was found to occur in 44.4% (4/9) of cases. Seven out of nine cases used Onyx, and two cases used n-butyl cyanoacrylate.

CONCLUSIONS

The Scepter Mini is a new dual lumen balloon ideal for distal access and can be used for embolization with liquid embolic agents with a high degree of technical success. Its great benefit is the immediate and safe flow arrest of distal vasculature upon balloon inflation. One important consideration for effective embolization is early identification of balloon jump back.

摘要

背景

在硬脑膜动静脉瘘(dAVF)和脑动静脉畸形(AVM)的血管内治疗中,使用液体栓塞剂已成为常规做法。双腔球囊微导管的使用极大地提高了液体栓塞的疗效。本系列旨在讨论我们在使用 Scepter Mini 双腔球囊微导管方面的早期经验。

方法

对在一家机构接受 Scepter Mini 双腔球囊栓塞治疗的所有患者进行回顾性图表审查。记录了每个病例的技术细节和程序并发症。

结果

共使用了 10 个 Scepter Mini 双腔球囊微导管在 9 名患者中。除了两名患者外,所有患者均接受 AVM 治疗。除了一个球囊因钽粉沉淀而不得不丢弃的情况外,所有病例均取得了技术成功。球囊充气的平均血管直径为 1.1 毫米(0.8-2.4 毫米)。在 100%的病例中,球囊充气提供了血流停止,没有栓塞材料反流的情况。发现 44.4%(4/9)的病例出现球囊“弹回”。9 例中有 7 例使用了 Onyx,2 例使用了 n-丁基氰基丙烯酸酯。

结论

Scepter Mini 是一种新的双腔球囊,非常适合远端进入,可用于液体栓塞剂栓塞,具有高度的技术成功率。其最大的优点是球囊充气后可立即安全地停止远端血管的血流。有效栓塞的一个重要考虑因素是早期识别球囊弹回。

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