Department of Radiology, University of Massachusetts Medical Center, Worcester, Massachusetts, USA.
Division of Neurointerventional Radiology, University of Massachusetts Medical Center, Worcester, Massachusetts, USA.
J Neurointerv Surg. 2023 Jul;15(7):664-668. doi: 10.1136/neurintsurg-2022-018806. Epub 2022 Jun 22.
Super large-bore aspiration (SLBA) has shown high rates of complete clot ingestion.
To report the initial clinical feasibility, safety, and efficacy of this novel SLBA insert combination-super large-bore ingestion of clot (SLIC) technique for stroke.
We performed a retrospective review of three comprehensive stroke center databases. The SLIC technique entails a triaxial assembly of an 8 Fr 0.106″ Base Camp catheter, 0.088″ catheter extender (HiPoint), and an insert catheter (Tenzing 8) that completely consumes the inner diameter of the 0.088″ SLBA catheter. The HiPoint catheter is delivered over the Tenzing 8 to the face of the embolus, which is withdrawn, while aspirating through the Base Camp and HiPoint catheters as a single assembly.
Thirty-three consecutive patients with large vessel occlusion were treated with SLIC. The median age was 70 years (30-91) and 17 were male (51.5%). The median presenting National Institutes of Health Stroke Scale score and Alberta Stroke Program Early CT score was 21 (1-34) and 8 (5-10), respectively. There was 100% success in delivering the 0.088″ catheter to the site of the occlusion. The successful revascularization rate (modified Thrombolysis in Cerebral Infarction (mTICI) score ≥2B) was 100% within a single pass in most cases (82%). Final mTICI ≥2C was achieved in 94.1% of occlusions, with 73.5% mTICI 3 recanalization. The rate of first pass effect in achieving excellent reperfusion (mTICI ≥2C) was 70.5%. There were no adverse events or postprocedural symptomatic hemorrhages.
Our initial experience with the SLIC technique resulted in achieving a first pass effect (mTICI ≥2C) in 70.5%. Navigation of the SLBA catheter extender over the Tenzing insert was successful and safe in this early experience.
大口径抽吸（SLBA）已显示出较高的完全血栓吸收率。
报告这种新型 SLBA 插入组合-大口径血栓吸收（SLIC）技术用于治疗中风的初步临床可行性、安全性和疗效。
我们对三个综合卒中中心数据库进行了回顾性分析。SLIC 技术采用 8Fr 0.106″Base Camp 导管、0.088″导管延长器（HiPoint）和插入导管（Tenzing 8）的三轴组件，该组件完全消耗 0.088″SLBA 导管的内径。HiPoint 导管通过 Tenzing 8 输送到栓子的表面，然后将其撤回，同时通过 Base Camp 和 HiPoint 导管进行抽吸作为一个整体。
33 例大血管闭塞患者接受了 SLIC 治疗。中位年龄为 70 岁（30-91 岁），17 例为男性（51.5%）。中位发病时 NIHSS 评分和 Alberta 卒中项目早期 CT 评分分别为 21（1-34）和 8（5-10）。在大多数情况下（82%），100%的患者成功将 0.088″导管输送至闭塞部位。大多数患者（82%）在单次通过时即可实现 100%的再通率（改良脑梗死溶栓（mTICI）评分≥2B）。94.1%的闭塞最终达到 mTICI≥2C，73.5%的 mTICI 3 级再通。实现良好再灌注（mTICI≥2C）的首次通过效应率为 70.5%。无不良事件或术后症状性出血。
我们使用 SLIC 技术的初步经验使首次通过效应（mTICI≥2C）达到 70.5%。在早期经验中，SLBA 导管延长器在 Tenzing 插入物上的导航是成功和安全的。
