Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Interventional Neuroradiology Unit, Carretera del Canyet, s/n, 08946, Badalona, Spain.
Stroke Unit, Hospital Universitari Dr. Josep Trueta, Girona, Spain.
Clin Neuroradiol. 2022 Jun;32(2):393-400. doi: 10.1007/s00062-021-01065-7. Epub 2021 Jul 20.
Large-bore aspiration catheters enabling greater flow rates and suction force for mechanical thrombectomy might improve outcomes in patients with stroke secondary to large-vessel occlusion. Complete or near-complete reperfusion after a single thrombectomy pass (first-pass effect) is associated with improved clinical outcomes. We assessed the efficacy and safety of novel MIVI Q™ aspiration catheters in combination with stent-retriever devices.
We retrospectively analyzed demographics, procedure characteristics, and clinical data from consecutive patients with acute anterior large-vessel occlusion treated with a combined approach using MIVI Q™ aspiration catheters and stent retrievers. Reperfusion was defined according to the modified thrombolysis in cerebral infarction (mTICI) score. Clinical outcomes were measured by the National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores.
We included 52 patients (median age, 75 y IQR: 64-83); 31 (59.6%) women; 14 (26.9%) with terminal internal carotid artery occlusions, 26 (50%) middle cerebral artery (MCA) segment M1 occlusions, and 12 (23.1%) MCA segment M2 occlusions; median NIHSS score at admission was 19 (IQR: 13-22). After the first pass, 25 (48%) patients had mTICI ≥ 2c. At the end of the procedure, 47 (90.4%) had mTICI ≥ 2b and 35 (67.3%) had mTICI ≥ 2c. No serious device-related adverse events were observed. Symptomatic intracranial hemorrhage developed in 1 patient. Mean NIHSS score was 13 at 24 h and 5 at discharge. At 90 days, 24 (46.2%) patients were functionally independent (mRS 0-2).
This preliminary study found good efficacy and safety for MIVI Q™ aspiration catheters used in combination with stent-retriever devices.
大口径抽吸导管能够提高机械血栓切除术的流速和抽吸力，可能改善大动脉闭塞引起的脑卒中患者的预后。单次抽吸通过（初次通过效应）实现完全或接近完全再灌注与改善临床预后相关。我们评估了新型 MIVI Q™抽吸导管联合支架取栓装置的疗效和安全性。
我们回顾性分析了连续接受 MIVI Q™抽吸导管联合支架取栓装置联合治疗的急性前循环大动脉闭塞患者的人口统计学、手术特征和临床资料。再灌注根据改良脑梗死溶栓（mTICI）评分定义。临床结局通过国立卫生研究院卒中量表（NIHSS）和改良 Rankin 量表（mRS）评分测量。
我们纳入了 52 例患者（中位数年龄 75 岁 IQR：64-83 岁）；31 例（59.6%）女性；14 例（26.9%）颈内动脉终末段闭塞，26 例（50%）大脑中动脉（MCA）M1 段闭塞，12 例（23.1%）MCA M2 段闭塞；入院时 NIHSS 中位数为 19 分（IQR：13-22 分）。初次通过后，25 例（48%）患者 mTICI≥2c。手术结束时，47 例（90.4%）患者 mTICI≥2b，35 例（67.3%）患者 mTICI≥2c。未观察到严重的器械相关不良事件。1 例患者出现症状性颅内出血。24 小时 NIHSS 评分平均值为 13 分，出院时为 5 分。90 天时，24 例（46.2%）患者功能独立（mRS 0-2）。
这项初步研究发现，MIVI Q™抽吸导管联合支架取栓装置具有良好的疗效和安全性。
