Matsumoto Shirabe, Imamura Hirotoshi, Takayanagi Ariel, Fukumitsu Ryu, Goto Masanori, Sunohara Tadashi, Fukui Nobuyuki, Omura Yoshihiro, Akiyama Tomoaki, Fukuda Tatsumaru, Go Koichi, Kajiura Shinji, Shigeyasu Masashi, Asakura Kento, Horii Ryo, Naramoto Yuji, Nishii Rikuo, Yamamoto Yasuhiro, Sakai Chiaki, Imahori Taichiro, Kaneko Naoki, Tateshima Satoshi, Sakai Nobuyuki
Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Division of Interventional Neuroradiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.
Interv Neuroradiol. 2025 Aug;31(4):532-538. doi: 10.1177/15910199231176709. Epub 2023 May 22.
BackgroundAn exchange maneuver is useful for the delivery of devices to target vessels. However, hemorrhagic complications can occur due to vessel perforation during an exchange maneuver. In addition, the exchange is often challenging due to unfavorable anatomy. Center Wire is an exchange-length wire with a nondetachable stent that was developed to improve navigation and stability during exchange maneuvers. The aim of this study is to investigate the safety and efficacy of Center Wire of the anchor wire technique during neuroendovascular treatment.MethodsTen patients with intracranial aneurysms were treated after signing a Certified Review Board-approved consent. Anchor wire technique was used in all patients to navigate catheters to the target vessel for aneurysm treatment.ResultsAnchor wire technique was successfully applied in all 10 cases using Center Wire. One device-related incident of vasospasm occurred which was asymptomatic. No device-related dissection, perforation, or thromboembolic events occurred. One patient had intraoperative aneurysm rupture during coil placement which was treated immediately without clinical consequences. Two patients had postoperative ischemic strokes due to thrombotic occlusion of branches originating from the aneurysm which were unrelated to the device.ConclusionsThis first-in-human trial of Center Wire demonstrated the safety and efficacy of the anchor wire technique for neuroendovascular treatment in a strictly regulated prospective registry trial.
背景
交换操作对于将器械输送至目标血管很有用。然而,在交换操作过程中,由于血管穿孔可能会发生出血性并发症。此外,由于解剖结构不利,交换操作通常具有挑战性。中心导丝是一种带有不可拆卸支架的交换长度导丝,其设计目的是在交换操作过程中提高导航性和稳定性。本研究的目的是调查在神经血管内治疗期间锚定导丝技术的中心导丝的安全性和有效性。
方法
10例颅内动脉瘤患者在签署经认证审查委员会批准的知情同意书后接受治疗。所有患者均采用锚定导丝技术将导管导航至目标血管以治疗动脉瘤。
结果
使用中心导丝,锚定导丝技术在所有10例病例中均成功应用。发生了1例与器械相关的无症状血管痉挛事件。未发生与器械相关的夹层、穿孔或血栓栓塞事件。1例患者在放置弹簧圈时术中动脉瘤破裂,立即进行了治疗,未产生临床后果。2例患者术后因动脉瘤起源分支的血栓闭塞发生缺血性卒中,与器械无关。
结论
在一项严格监管的前瞻性注册试验中,这项中心导丝的首次人体试验证明了锚定导丝技术在神经血管内治疗中的安全性和有效性。