Ali Aizaz, Rao Rahul, Sharkey Brandon, Gega Alisa, Oliver Marion, Chen Tahao, Burgess Richard, Jumaa Mouhammad, Zaidi Syed
College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA.
Department of Neurology, Promedica Toledo Hospital, Toledo, OH, USA.
Interv Neuroradiol. 2024 Jul 25:15910199241264328. doi: 10.1177/15910199241264328.
Thrombectomy for medium vessel occlusion is a topic of great interest. We describe a single-center experience with the Penumbra 3-MAX aspiration catheter in stroke thrombectomy of medium vessel occlusion(MeVO). We investigated the use of 3-MAX as a de-novo first pass catheter and as a rescue aspiration device following attempted thrombectomy with other devices. This is the first description of the first pass effect and successful recanalization rate of the 3-MAX catheter in de-novo vs. rescue use of this catheter.
From January 2017 to January 2023, 84 patients underwent mechanical thrombectomy with use of a Penumbra 3MAX aspiration catheter at our comprehensive stroke center. Patient charts were retrospectively reviewed. Primary efficacy outcome was successful recanalization following mechanical thrombectomy. Primary safety outcome was intracerebral hemorrhage.
A total of 84 patients underwent MT with the 3MAX device. It was used as a de novo catheter in 27(32.1%) and as a rescue catheter in 57(67.9%) patients. 35(41.6%) patients achieved angiographic TICI grade ≥ 2c. De novo 3MAX use led to 68.18% successful recanalization and rescue use led to 72.22% recanalization (p = 0.67) as measured by TICI score of 2c or better. Parenchymal intracerebral hemorrhages (PH) were present in 8 patients (9.5%).
The Penumbra 3MAX catheter is safe and effective when used as a first pass or a rescue device in mechanical thrombectomy. We found similar rates of successful recanalization and minimal hemorrhagic risk when comparing the 3MAX as a rescue or de novo aspiration catheter.
中血管闭塞的血栓切除术是一个备受关注的话题。我们描述了在中血管闭塞（MeVO）的卒中血栓切除术中使用Penumbra 3-MAX抽吸导管的单中心经验。我们研究了将3-MAX用作初始首次通过导管以及在使用其他装置进行血栓切除术后用作补救抽吸装置的情况。这是首次描述3-MAX导管在初始使用与补救使用时的首次通过效果和成功再通率。
2017年1月至2023年1月，84例患者在我们的综合卒中中心使用Penumbra 3MAX抽吸导管进行了机械血栓切除术。对患者病历进行了回顾性分析。主要疗效指标是机械血栓切除术后的成功再通。主要安全指标是脑出血。
共有84例患者使用3MAX装置进行了MT。其中27例（32.1%）患者将其用作初始导管，57例（67.9%）患者将其用作补救导管。35例（41.6%）患者实现了血管造影TICI分级≥2c。根据TICI评分为2c或更好来衡量，初始使用3MAX导致68.18%的成功再通，补救使用导致72.22%的再通（p = 0.67）。8例患者（9.5%）出现脑实质内出血（PH）。
Penumbra 3MAX导管在机械血栓切除术中用作首次通过或补救装置时是安全有效的。我们发现，将3MAX用作补救或初始抽吸导管时，成功再通率相似且出血风险最小。
