Hassan Ameer E, Burke Elizabeth M, Monayao Marlon, Tekle Wondwossen G
Department of Neurology, University of Texas Rio Grande Valley, Harlingen, TX, United States.
Department of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, United States.
Front Neurol. 2021 May 7;12:578446. doi: 10.3389/fneur.2021.578446. eCollection 2021.
The rise of neurointerventional devices has created a demand for guide systems capable of navigating to the carotid artery consistently regardless of tortuosity. The shift toward large distal access catheters (DACs) and desire for greater trackability have inspired the creation of flexible, supportive, large-lumen long guiding sheaths. Recently, the Ballast long guiding sheath was introduced to provide stability and flexibility while navigating neurointerventional devices through tortuous intracranial anatomy. To report our experience using the Ballast long guiding sheath in a series of patients undergoing a variety of neuroendovascular procedures. We retrospectively identified all patients who underwent neuroendovascular treatment with a long guiding sheath were selected from a prospectively maintained endovascular database from January 2019 to November 2019. Baseline clinical characteristics and procedural details were collected. A total of 68 patients were included, mean patient age 67.6 ± 13.6 years. Of the patients treated, 52.9% (36/68) presented with stenosis, 25% (17/68) with aneurysms, 13.2% (9/68) with stroke or emboli, 1.5% (1/68) with a tumor, 1.5% (1/68) with an arteriovenous fistula (AVF), and 4.4% (3/68) with a carotid web. Of the patients with stenosis, 20/36 (55.6%) were extracranial, and 16/36 (44.4%) were intracranial. The Ballast long guiding sheath was used to deliver treatment devices for stenting (37/68, 54.4%), flow diversion (12/68, 17.6%), mechanical thrombectomy (8/68, 11.8%), endovascular coiling (5/68, 7.4%), liquid embolization (3/68, 4.4%), balloon angioplasty (2/68, 2.9%), and balloon angioplasty with stenting (1/68, 1.5%). No Ballast-related complications or adverse events were encountered. We demonstrate the feasibility of the Ballast long guiding sheath to successfully deliver modern neurointerventional treatment devices through tortuous anatomy.
神经介入设备的兴起引发了对导向系统的需求，这种导向系统无论血管弯曲程度如何，都能始终如一地导航至颈动脉。向大型远端接入导管（DAC）的转变以及对更高可追踪性的需求，促使人们研发出了灵活、支撑性好、大腔径的长引导鞘。最近，推出了Ballast长引导鞘，以便在通过复杂的颅内解剖结构导航神经介入设备时提供稳定性和灵活性。报告我们在一系列接受各种神经血管内手术的患者中使用Ballast长引导鞘的经验。我们回顾性地确定了2019年1月至2019年11月期间，从前瞻性维护的血管内数据库中选取的所有接受神经血管内治疗且使用了长引导鞘的患者。收集了基线临床特征和手术细节。共纳入68例患者，患者平均年龄为67.6±13.6岁。在接受治疗的患者中，52.9%（36/68）表现为狭窄，25%（17/68）为动脉瘤，13.2%（9/68）为中风或栓子，1.5%（1/68）为肿瘤，1.5%（1/68）为动静脉瘘（AVF），4.4%（3/68）为颈动脉蹼。在狭窄患者中，20/36（55.6%）为颅外狭窄，16/36（44.4%）为颅内狭窄。Ballast长引导鞘用于输送治疗设备进行支架置入（37/68，54.4%）、血流导向（12/68，17.6%）、机械取栓（8/68，11.8%）、血管内栓塞（5/68，7.4%）、液体栓塞（3/68，4.4%）、球囊血管成形术（2/68，2.9%）以及球囊血管成形术联合支架置入（1/68，1.5%）。未遇到与Ballast相关的并发症或不良事件。我们证明了Ballast长引导鞘通过复杂解剖结构成功输送现代神经介入治疗设备的可行性。
