Campos Jessica K, Meyer Benjamen M, Khan Muhammad Waqas, Laghari Fahad J, Zarrin David A, Collard de Beaufort Jonathan, Amin Gizal, Golshani Kiarash, Bender Matthew T, Colby Geoffrey P, Lin Li-Mei, Coon Alexander L
Department of Neurological Surgery, University of California Irvine, Orange, CA, USA.
University of Arizona, College of Medicine, Tucson, AZ, USA.
Interv Neuroradiol. 2024 Feb 28:15910199241229198. doi: 10.1177/15910199241229198.
Superbore 0.088″ catheters provide a platform for optimizing aspiration efficiency and flow control during stroke mechanical thrombectomy procedures. New superbore catheters have the distal flexibility necessary to navigate complex neurovascular anatomy while providing the proximal support of traditional 8F catheters. The safety and feasibility of Zoom 88™ superbore angled-tip catheters in the middle cerebral artery (MCA) segments smaller than the catheter diameter have not been previously described.
Twenty consecutive cases of acute MCA mechanical thrombectomy were retrospectively identified from the senior authors' prospectively maintained Institutional Review Board-approved database, in which the Zoom 88 (Imperative Care, Campbell, CA) catheter was successfully navigated to at least the M1 segment. Patient demographics, procedural details, and periprocedural information were analyzed. Rates and averages (standard errors) are generally reported.
The average National Institutes of Health Stroke Scale at presentation and age were 15 ± 2 and 73 ± 3 years, respectively. The M1 and M2 occlusions were evenly distributed. The average M1 measurements before thrombectomy ranged from 2.36 ± 0.07 mm proximally to 2.00 ± 0.11 mm distally, and after thrombectomy, they ranged from 2.34 ± 0.07 mm proximally to 1.97 ± 0.10 mm distally. First-pass modified thrombolysis in cerebral infarction (mTICI) 2C/3 recanalization was achieved in 40% of cases, and final mTICI 2C/3 recanalization was achieved in 90% of cases. A single case of mild vasospasm was managed with verapamil. No hemorrhagic or periprocedural complications were noted.
Superbore 0.088″ catheters with flexible distal segments can be safely navigated to the MCA to augment mechanical thrombectomy even when the MCA segment is smaller than the catheter.
Superbore 0.088英寸导管为在卒中机械取栓手术中优化抽吸效率和流量控制提供了一个平台。新型Superbore导管具有远端灵活性，能够在复杂的神经血管解剖结构中导航，同时提供传统8F导管的近端支撑。此前尚未描述过Zoom 88™ Superbore斜角尖端导管在小于导管直径的大脑中动脉（MCA）节段中的安全性和可行性。
从资深作者前瞻性维护的、经机构审查委员会批准的数据库中回顾性确定了20例连续的急性MCA机械取栓病例，其中Zoom 88（Imperative Care，加利福尼亚州坎贝尔）导管成功导航至至少M1节段。分析了患者人口统计学、手术细节和围手术期信息。一般报告发生率和平均值（标准误差）。
就诊时平均美国国立卫生研究院卒中量表评分和年龄分别为15±2分和73±3岁。M1和M2闭塞分布均匀。取栓术前M1的平均测量值近端为2.36±0.07mm，远端为2.00±0.11mm；取栓术后，近端为2.34±0.07mm，远端为1.97±0.10mm。40%的病例实现了首次通过改良脑梗死溶栓（mTICI）2C/3级再通，90%的病例实现了最终mTICI 2C/3级再通。1例轻度血管痉挛用维拉帕米治疗。未发现出血或围手术期并发症。
即使MCA节段小于导管，具有灵活远端节段的Superbore 0.088英寸导管也可安全导航至MCA以增强机械取栓效果。
