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研究者发起的稳定器装置临床试验:一种用于神经血管内治疗的新型颅内交换导丝。

Investigator-initiated clinical trial of stabilizer device: A novel intracranial exchange guidewire for neuroendovascular treatments.

作者信息

Sakai Chiaki, Sakai Nobuyuki, Peterson Catherine, Ohta Tsuyoshi, Oishi Hidenori, Fujinaka Toshiyuki, Matsumaru Yuji, Ishii Akira, Imamura Hirotoshi, Yoshimura Shinichi, Izumi Takashi, Satow Tetsu, Ito Yasushi, Sugiu Kenji, Miyachi Shigeru, Hirano Teruyuki, Kagimura Tatsuo, Kaneko Naoki, Tateshima Satoshi

机构信息

Department of Neurosurgery, Kyoto University, Kyoto, Japan.

Department of Neurovascular Research, Kobe City Medical Center General Hospital, Kobe, Japan.

出版信息

Interv Neuroradiol. 2024 Aug 7:15910199241262851. doi: 10.1177/15910199241262851.

Abstract

BACKGROUND

Neuroendovascular procedures, especially those involving significant vessel tortuosity, giant intracranial aneurysms, or distally located lesions, frequently necessitate exchange methods. However, exchange maneuvers pose a risk of inadvertent vessel injury. To address these challenges, a Stabilizer device was developed and evaluated for its efficacy and safety. This clinical trial aimed to assess the efficacy and safety of the Stabilizer device in facilitating the navigation of neuroendovascular devices to target lesions in cases where the exchange technique was necessary.

METHODS

This was a single-arm, prospective, open-label, multicenter clinical trial performed at nine different sites. It focused on investigating the use of the Stabilizer device for treating intracranial aneurysms and atherosclerosis.

RESULTS

A total of 31 patients were enrolled across nine centers in Japan from July 21, 2022, to March 10, 2023. The study enrolled 24 (77.4%) patients with intracranial aneurysms and seven (22.6%) patients with intracranial artery stenosis. Majority of the target lesions were in the middle cerebral artery territory (83.9%). The Stabilizer device was used to exchange for 0.027-inch catheters, intermediate catheters, PTA balloons, and Wingspan stent system. The Stabilizer device demonstrated 100% technical success rate. While three complications related to the treatment were noted, there were no complications related to the device, including any vascular damage.

CONCLUSIONS

This is the first multicenter clinical trial that investigated and demonstrated technical efficacy as well as overall safety profile of the Stabilizer device in neuroendovascular procedures where the use of an exchange method was necessary.

摘要

背景

神经血管介入手术,尤其是那些涉及严重血管迂曲、巨大颅内动脉瘤或远端病变的手术,常常需要采用交换技术。然而,交换操作存在意外血管损伤的风险。为应对这些挑战,研发了一种稳定器装置并对其有效性和安全性进行评估。本临床试验旨在评估稳定器装置在需要交换技术的情况下,辅助神经血管介入装置导航至目标病变的有效性和安全性。

方法

这是一项在九个不同地点进行的单臂、前瞻性、开放标签的多中心临床试验。重点研究稳定器装置在治疗颅内动脉瘤和动脉粥样硬化中的应用。

结果

从2022年7月21日至2023年3月10日,日本九个中心共纳入31例患者。该研究纳入了24例(77.4%)颅内动脉瘤患者和7例(22.6%)颅内动脉狭窄患者。大多数目标病变位于大脑中动脉区域(83.9%)。稳定器装置用于交换0.027英寸导管、中间导管、经皮腔内血管成形术球囊和Wingspan支架系统。稳定器装置的技术成功率为100%。虽然记录到3例与治疗相关的并发症,但没有与该装置相关的并发症,包括任何血管损伤。

结论

这是第一项多中心临床试验,研究并证明了稳定器装置在需要使用交换技术的神经血管介入手术中的技术有效性和整体安全性。

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