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使用大型手动可扩张支架取栓器(Tiger XL装置)治疗急性颈内动脉末端闭塞的机械取栓术:多中心初步经验

Mechanical Thrombectomy in Acute Terminal Internal Carotid Artery Occlusions Using a Large Manually Expandable Stentretriever (Tiger XL Device): Multicenter Initial Experience.

作者信息

Maus Volker, Hüsken Sabeth, Kalousek Vladimir, Karwacki Grzegorz Marek, Nordmeyer Hannes, Kleffner Ilka, Weber Werner, Fischer Sebastian

机构信息

Knappschaftskrankenhaus Bochum-Langendreer-Universitätsklinik, Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie, Nuklearmedizin, In der Schornau 23-25, 44892 Bochum, Germany.

Subdivision of Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center Sisters of Mercy, 10000 Zagreb, Croatia.

出版信息

J Clin Med. 2021 Aug 27;10(17):3853. doi: 10.3390/jcm10173853.

Abstract

BACKGROUND

The recently introduced Tigertriever XL Device for treatment of cerebral vessel occlusions combines manual adjustability and maximum length in one device. In this study, we report our initial experience with the Tigertriever XL in terminal ICA occlusions.

METHODS

Retrospective multicenter analysis of acute terminal ICA occlusions treated by mechanical thrombectomy using the Tigertriever XL Device.

RESULTS

23 patients were treated using the Tigetriever XL due to an acute occlusion of the terminal ICA. The overall successful reperfusion rate after a median of two maneuvers using the Tigertriever XL Device was 78.3% (mTICI 2b-3). In 43.5% (10/23) additional smaller devices were applied to treat remaining occlusions in downstream territories, which resulted in a final successful reperfusion rate of 95.7%. Device related complications did not occur. Two symptomatic intracerebral hemorrhages (sICH) were observed.

CONCLUSIONS

The Tigertriever XL Device might be a helpful tool in the treatment of ICA terminus occlusions with large clot burden resulting in high reperfusion rates. This is mainly related to the manual adjustability of the device combined with the maximum length.

摘要

背景

最近推出的用于治疗脑血管闭塞的Tigertriever XL装置在一个装置中结合了手动可调节性和最大长度。在本研究中,我们报告了我们使用Tigertriever XL治疗颈内动脉末端闭塞的初步经验。

方法

对使用Tigertriever XL装置进行机械取栓治疗的急性颈内动脉末端闭塞进行回顾性多中心分析。

结果

23例患者因颈内动脉末端急性闭塞接受了Tigetriever XL治疗。使用Tigertriever XL装置经中位数两次操作后的总体成功再灌注率为78.3%(mTICI 2b-3)。在43.5%(10/23)的患者中,应用了额外的较小装置来治疗下游区域的残余闭塞,最终成功再灌注率为95.7%。未发生与装置相关的并发症。观察到2例症状性脑出血(sICH)。

结论

Tigertriever XL装置可能是治疗颈内动脉末端闭塞且血栓负荷大导致高再灌注率的有用工具。这主要与该装置的手动可调节性和最大长度相结合有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bba/8432012/e9e27f4809bb/jcm-10-03853-g001.jpg

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