Marangoni Marco, Macdonald Ian R, Pickett Gwynedd E, Weeks Adrienne, Kim Cha-Ney, Rohr Axel, Guest William, Heran Manraj K S, Volders David
Division of Interventional Neuroradiology, Department of Radiology, University of British Columbia, Vancouver, BC, Canada.
Division of Neuroradiology, Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada.
Interv Neuroradiol. 2024 Jun 14:15910199241261756. doi: 10.1177/15910199241261756.
Radial arterial access has gained interest for neurovascular procedures in recent years. Although there are no randomized control trials for neurointervention procedures using radial access, there is growing literature demonstrating its feasibility and favorable outcomes. Equipment technical improvements, like the recently introduced BENCHMARK™ BMX®81 System, have made radial navigation safer, with improved maneuverability and support for a variety of procedures. We present a multicenter case series highlighting our institutional radial access experience comparing the BMX®81 with alternative catheters.
Multicenter retrospective cohort study of 80 patients who underwent neurovascular procedures through a radial approach. In half of the cases a BENCHMARK™ BMX®81 System was used. The comparison group consisted of the BENCHMARK™071 and 96, Neuron MAX®088 and BALLAST™ systems. Procedures included endovascular thrombectomy, carotid and brachiocephalic artery stenting, middle meningeal artery embolization, flow diverter stenting, vertebral artery sacrifice, aneurysm coiling, and WEB™ device deployment.
In our series, the BMX®81 was successful in the navigation of the anatomy to the target location in 95% of cases. No radial access or BMX®81 related complications were identified. There was no significant difference in fluoroscopy time between the BMX81 and the comparison group. Four patients in the comparison group had catheter-related complications due to vasospasm. Eighty-six percent of BMX®81 cases had satisfactory outcomes and no technical difficulties. The remainder presented technical difficulties, but none of these were considered secondary to the puncture site or support structure.
The BENCHMARK™ BMX®81 System is a recently developed guiding catheter which has design and size features supporting radial access for a variety of neurovascular interventions. Early multicenter experience highlights the ease of use and versatility of this new catheter as an alternative to transfemoral access as well as other catheters used for radial access.
近年来,桡动脉入路在神经血管介入手术中受到关注。尽管目前尚无关于使用桡动脉入路进行神经介入手术的随机对照试验,但越来越多的文献表明其具有可行性和良好的效果。设备技术的改进,如最近推出的BENCHMARK™ BMX®81系统,使桡动脉导航更安全,操作灵活性更高,且能支持多种手术。我们展示了一个多中心病例系列,突出了我们机构使用桡动脉入路的经验,并将BMX®81与其他导管进行了比较。
对80例通过桡动脉入路进行神经血管介入手术的患者进行多中心回顾性队列研究。其中一半病例使用了BENCHMARK™ BMX®81系统。对照组包括BENCHMARK™071和96、Neuron MAX®088以及BALLAST™系统。手术包括血管内血栓切除术、颈动脉和头臂动脉支架置入术、脑膜中动脉栓塞术、血流导向支架置入术、椎动脉闭塞术、动脉瘤栓塞术以及WEB™装置置入术。
在我们的病例系列中,BMX®81在95%的病例中成功将解剖结构导航至目标位置。未发现与桡动脉入路或BMX®81相关的并发症。BMX81组与对照组的透视时间无显著差异。对照组中有4例患者因血管痉挛出现导管相关并发症。86%的BMX®81病例取得了满意的效果,且无技术困难。其余病例存在技术困难,但均不被认为是穿刺部位或支撑结构所致。
BENCHMARK™ BMX®81系统是一种最新研发的引导导管,其设计和尺寸特点支持多种神经血管介入手术的桡动脉入路。早期多中心经验突出了这种新型导管作为经股动脉入路以及其他用于桡动脉入路的导管的替代方案时的易用性和多功能性。