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一种新型颅内交换导丝改善了各种血管内装置的导航:具有挑战性情况的体外研究。

A novel intracranial exchange guidewire improves the navigation of various endovascular devices: An in vitro study of challenging situations.

作者信息

Kaneko Naoki, Takayanagi Ariel, Saber Hamidreza, Guo Lea, Tateshima Satoshi

机构信息

Department of Radiological Sciences, David Geffen School of Medicine, 8783University of California Los Angeles, Los Angeles, CA, USA.

Department of Neurological Surgery, 472028Riverside University Health System, Moreno Valley, CA, USA.

出版信息

Interv Neuroradiol. 2022 Oct;28(5):588-594. doi: 10.1177/15910199211057332. Epub 2021 Nov 17.

Abstract

OBJECTIVE

Neuroendovascular procedures rely on successful navigation and stable access to the target vessel. The Stabilizer is a 300 cm long exchange wire with a 0.014 diameter and a soft, flexible stent at the distal end designed to assist with navigation and device delivery. This study aims to assess the efficacy of the Stabilizer for navigation in a variety of challenging environments.

METHODS

The efficacy of the Stabilizer was evaluated using three challenging vascular models: a giant aneurysm model, a severe tortuosity model, and an M1 stenosis model. The Stabilizer was compared with a conventional wire during navigation in each model.

RESULTS

In the giant aneurysm model, there was no significant difference of success during straightening of a looped wire and significantly higher success rates when advancing an intermediate catheter with the Stabilizer beyond the aneurysm neck compared to a conventional guidewire. The Stabilizer also significantly increased success rates when advancing an intermediate catheter through a model with severe tortuosity compared to a conventional guidewire, as well as exchange maneuver for intracranial stenting in a stenosis model compared to an exchange wire.

CONCLUSIONS

In our experimental model, the Stabilizer significantly improved navigation and device delivery in a variety of challenging settings compared to conventional wires.

摘要

目的

神经血管介入手术依赖于成功的导航和对目标血管的稳定进入。稳定器是一根300厘米长、直径0.014的交换导丝,其远端有一个柔软、灵活的支架,旨在辅助导航和器械输送。本研究旨在评估稳定器在各种具有挑战性的环境中进行导航的效果。

方法

使用三种具有挑战性的血管模型评估稳定器的效果:巨大动脉瘤模型、严重迂曲模型和M1段狭窄模型。在每个模型的导航过程中,将稳定器与传统导丝进行比较。

结果

在巨大动脉瘤模型中,与传统导丝相比,在将盘绕的导丝拉直过程中成功率无显著差异,但使用稳定器推进中间导管越过动脉瘤颈部时成功率显著更高。与传统导丝相比,在通过严重迂曲模型推进中间导管时,稳定器也显著提高了成功率,并且在狭窄模型中与交换导丝相比,在进行颅内支架置入的交换操作时成功率也显著提高。

结论

在我们的实验模型中,与传统导丝相比,稳定器在各种具有挑战性的情况下显著改善了导航和器械输送。

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