Kim Sum, Lee Jong Young
Department of Neurosurgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
Front Neurol. 2022 Oct 6;13:978584. doi: 10.3389/fneur.2022.978584. eCollection 2022.
Aspiration thrombectomy is used to treat endovascular stroke treatment by clot removal through vacuum and suction forces. We aimed to investigate the pressures and suction forces generated by different pump systems for aspiration.
Vacuum pressure was measured using a vacuum gauge with a closed tip for a 60cc syringe and aspiration pumps. Using an artificial thrombus made from polyvinyl alcohol hydrogel and latex membrane, we assessed the catheter tip force generated on an artificial thrombus using 5Fr Sofia and 6Fr Sofia PLUS intermediate catheters combined with Penumbra Jet Engine or Stryker Medela AXS Universal Aspiration Set. Subsequently, we calculated the catheter tip forces based on the pressure [catheter tip size (force = area × pressure)], and compared with the measured catheter tip force.
The 60cc syringe generated the highest vacuum pressure. Among the automatic pumps, the Penumbra jet engine generated the highest vacuum pressure. The catheter tip forces on the artificial thrombus and latex membrane were 18.5 ± 1.70 and 8.0 ± 1.23 gf, respectively, and 13.9 ± 1.37 and 5.6 ± 0.83 gf, respectively using the 5 Fr Sofia with the Penumbra Jet Engine and the Stryker Medela AXS Universal Aspiration Set, respectively. The corresponding values for the 6 Fr Sofia PLUS with the Penumbra Jet Engine and Stryker Medela AXS Universal Aspiration Set were 39.7 ± 3.88 and 20.7 ± 0.92 gf and 25.4 ± 4.96 and 18.0 ± 0.84 gf. For a constant catheter diameter and the automatic pump, the catheter tip force was significantly larger in the artificial thrombus than latex membrane ( < 0.001, ANOVA).
The catheter diameter, vacuum pressure, and clot softness are positively correlated with the catheter tip force.
抽吸血栓切除术用于通过真空和吸力清除血栓来治疗血管内中风。我们旨在研究不同抽吸泵系统产生的压力和吸力。
使用带有封闭尖端的真空计测量60cc注射器和抽吸泵的真空压力。使用由聚乙烯醇水凝胶和乳胶膜制成的人工血栓,我们评估了结合Penumbra Jet Engine或Stryker Medela AXS通用抽吸套件的5Fr Sofia和6Fr Sofia PLUS中间导管在人工血栓上产生的导管尖端力。随后,我们根据压力计算导管尖端力[导管尖端尺寸(力=面积×压力)],并与测量的导管尖端力进行比较。
60cc注射器产生的真空压力最高。在自动泵中,Penumbra喷气发动机产生的真空压力最高。使用Penumbra Jet Engine的5Fr Sofia和Stryker Medela AXS通用抽吸套件时,人工血栓和乳胶膜上的导管尖端力分别为18.5±1.70 gf和8.0±1.23 gf,以及13.9±1.37 gf和5.6±0.83 gf。使用Penumbra Jet Engine和Stryker Medela AXS通用抽吸套件的6Fr Sofia PLUS的相应值分别为39.7±3.88 gf和20.7±0.92 gf,以及25.4±4.96 gf和18.0±0.84 gf。对于恒定的导管直径和自动泵,人工血栓中的导管尖端力明显大于乳胶膜(方差分析,<0.001)。
导管直径、真空压力和血栓柔软度与导管尖端力呈正相关。