Department of Neuroradiology, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Via San Leonardo 1, 84100, Salerno, Italy.
Department of Neuroradiology, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Via San Leonardo 1, Salerno, Italy.
BMC Neurol. 2022 Jul 12;22(1):258. doi: 10.1186/s12883-022-02784-1.
To describe technical features and initial results of a novel large-bore reperfusion catheter as first thromboaspiration approach for endovascular stroke treatment in terminal internal carotid artery (T-ICA) occlusions.
All patients treated with A Direct Aspiration first-Pass Technique (ADAPT) using JET 7 "Standard Tip" Penumbra Reperfusion catheter for acute T-ICA occlusion were retrospectively included in the study. Baseline data, puncture to recanalization time, number of attempts, switch to second device/technique rate and successful recanalization rate were assessed. Successful recanalization was defined by a thrombolysis in cerebral infarction (TICI) score ≥ 2b and favorable functional outcome was defined according to modified Rankin scale (score, 0-2). Catheter specifics and thromboaspiration reperfusion technique with JET 7 were reported.
A total of 21 patients who underwent ADAPT with JET 7 Reperfusion catheter were enrolled for the final analysis. ADAPT was performed as first approach in all cases (100%). First attempt successful recanalization (eTICI ≥2b) was obtained in 90,5% of cases. Mean puncture to recanalization time was 16 minutes. Final successful recanalization was reached in 96.5%. Functional independence at 90 was achieved in 57,1% cases. Symptomatic intracranial hemorrhage occurred in one patient within 24 h.
The large-bore JET 7 reperfusion catheter could be considered as first-line in patients with acute T-ICA occlusion, allowing rapid recanalization and low rate of rescue therapy with stent retriver. Further series and/or trial evaluation are required to confirm our results.
描述一种新型大口径再通导管的技术特点和初步结果,该导管作为经血管内治疗终段颈内动脉(T-ICA)闭塞的首选血栓抽吸方法。
回顾性纳入所有使用 JET 7“标准尖端”Penumbra 再通导管进行急性 T-ICA 闭塞的 ADAPT 治疗的患者。评估基线数据、穿刺至再通时间、尝试次数、转换至第二器械/技术的比率和再通成功率。成功再通定义为血栓溶解程度(TICI)评分≥2b,根据改良Rankin 量表(评分 0-2)定义良好的功能结局。报告了导管的具体情况和 JET 7 的血栓抽吸再通技术。
共有 21 例患者接受了 JET 7 再通导管的 ADAPT 治疗,最终纳入了 21 例患者进行最终分析。所有病例均采用 ADAPT 作为首选方法(100%)。90.5%的病例首次尝试即达到成功再通(eTICI≥2b)。平均穿刺至再通时间为 16 分钟。最终再通成功率为 96.5%。90 天时达到功能独立性的患者比例为 57.1%。1 例患者在 24 小时内发生症状性颅内出血。
大口径 JET 7 再通导管可作为急性 T-ICA 闭塞患者的一线治疗方法,可实现快速再通,且支架取栓术的挽救治疗率较低。需要进一步的系列研究或临床试验来证实我们的结果。