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经皮血管内治疗的新范例:Bendit 可控微导管的临床应用经验。

Clinical experience with the Bendit steerable microcatheter: a new paradigm for endovascular treatment.

机构信息

Neurology/Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.

Department of Interventional Neuroradiology, Alfried Krupp Hospital Ruttenscheid, Essen, Germany.

出版信息

J Neurointerv Surg. 2023 Aug;15(8):771-775. doi: 10.1136/jnis-2022-019096. Epub 2022 Jul 19.

Abstract

BACKGROUND

Vessel tortuosity poses a challenge during endovascular treatment of neurovascular lesions. Bendit Technologies (Petah Tikva, Israel) has developed flexible, steerable microcatheters designed with unique bending and torquing capabilities.

OBJECTIVE

To describe our first-in-human trial of Bendit21.

METHODS

Bendit21 was used in our exploratory, prospective, multicenter, open-label, single-arm clinical study, and in two compassionate use cases. Procedures were conducted at four centers in Austria, Germany, Israel, and the United States between May 2021 and March 2022, in patients with neurovascular conditions. The primary endpoints were device-related safety events, successful navigation through the neurovasculature, and, when intended, successful delivery of contrast or therapy.

RESULTS

Two patients with giant aneurysms were treated successfully under compassionate use approval. The clinical study included 25 patients (mean age: 63.4±11.8 years; 32.0% female). Fourteen patients (56.0%) had aneurysms, two had arteriovenous malformations/fistulas (8.0%), one had a stroke (4.0%), four (16.0%) had intracranial stenosis, and four (16.0%) had other conditions. Bendit21 was used without a guidewire in 12/25 (48.0%) procedures. Bendit21 was successfully navigated through the vasculature without delays or spasms in all cases (100%). Contrast was delivered as intended in 7/7 (100%) cases. Therapeutic devices were delivered successfully with Bendit as intended in 14/18 (77.8%) cases; four deficiencies occurred in three patients with aneurysms, in whom delivery of coils, an intrasaccular device, or a flow diverter was attempted. There were no device-related safety events or mortalities.

CONCLUSIONS

Our initial clinical experience with the Bendit21 microcatheter demonstrates its usefulness in achieving technical success in patients with challenging neurovascular conditions.

摘要

背景

在治疗神经血管病变时,血管迂曲给血管内治疗带来了挑战。Bendit Technologies(以色列佩塔提克瓦)开发了具有独特弯曲和转向能力的灵活可控微导管。

目的

介绍 Bendit21 的首次人体临床试验。

方法

在我们的探索性、前瞻性、多中心、开放标签、单臂临床研究中,以及在两个同情使用案例中,使用了 Bendit21。该研究于 2021 年 5 月至 2022 年 3 月在奥地利、德国、以色列和美国的四个中心进行,入组患有神经血管疾病的患者。主要终点为器械相关安全性事件、成功通过神经血管、以及在预期情况下成功输送造影剂或治疗。

结果

两名患有巨大动脉瘤的患者在同情使用批准下成功接受了治疗。临床研究共纳入 25 名患者(平均年龄:63.4±11.8 岁;32.0%为女性)。14 名患者(56.0%)患有动脉瘤,2 名患者患有动静脉畸形/瘘(8.0%),1 名患者患有脑卒中(4.0%),4 名患者(16.0%)患有颅内狭窄,4 名患者(16.0%)患有其他疾病。在 25 例手术中,12 例(48.0%)未使用导丝。在所有病例中,Bendit21 均成功通过血管,无延迟或痉挛(100%)。7/7(100%)例预期输送造影剂。18 例中有 14 例(77.8%)按预期使用 Bendit 输送治疗设备,3 名患者中的 4 例存在缺陷,这些患者尝试输送线圈、腔内装置或血流导向装置。无器械相关安全性事件或死亡。

结论

我们对 Bendit21 微导管的初步临床经验表明,在治疗具有挑战性的神经血管疾病患者时,它有助于实现技术成功。

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