Interventional Neuro Associates, New York, NY, USA.
Interventional Neuro Associates, New York, NY, USA.
Clin Neurol Neurosurg. 2024 Dec;247:108625. doi: 10.1016/j.clineuro.2024.108625. Epub 2024 Oct 30.
Aspiration thrombectomy is one of the mainstays for stroke interventions. The Zoom 71 (Z71) aspiration catheter is unique with its angled tip. This study describes the orientation of the angled tip as it is navigated around the carotid siphon in relation to trackability.
Prospectively collected cases involving large vessel occlusions of the anterior circulation intervened upon using the Z71 were retrospectively analyzed. 71 passes in 50 patients were analyzed with respect to Z71 tip orientation. 3 anatomical "turns" were defined as follows: "1": proximal cavernous, "2"- ophthalmic turn, and "3"-ICA terminus to M1. The tip was described as "Toward" Vs "Away" with respect to the inner curve of each turn. The tip getting "caught" was also analyzed.
There was no preferential angled tip orientation of the Z71 as it was navigated around "Turn 1", 51 % "Away" vs 44 % "Toward", p= 0.54; "2", 46.5 % "Away" vs 53.5 % "Toward", p= 0.55; and "3", 43.7 % "Away" vs 46.5 % "Toward", p=0.63. The tip was not caught in Turn 1. It was caught up in "2" in 15.5 % of passes. "Away" at "2" got caught up in 21 % of passes vs 10.5 % for "Toward", p= 0.22. Z71 got caught up in "3" in 4.7 % of passes. "Away" was associated with getting caught in 6.5 % of passes vs 3 % for "Toward", p=0.52. Zoom 88 (Z88) usage as guide catheter may be associated with Z71 getting caught less in "2" compared to "Others", 9.3 % for Z88 vs 25 %, p= 0.07. This also applied to Turn 3, 0 % for Z88 vs 11.1 %, p=0.038.
There is no preferential angled tip orientation of the Z71 as it navigates around the carotid siphon. The tip orientation does not appear to significantly affect navigation. Usage of Z88 as guide catheter helps with Z71 trackability around the siphon.
抽吸血栓切除术是卒中介入治疗的主要方法之一。Zoom 71（Z71）抽吸导管的独特之处在于其成角的尖端。本研究描述了在颈动脉虹吸内导航时尖端的方向与可跟踪性的关系。
前瞻性收集使用 Z71 治疗的前循环大血管闭塞的病例，回顾性分析。对 50 例患者的 71 次操作进行分析，以评估 Z71 尖端的方向。定义了 3 个解剖“转弯”：“1”：近端海绵窦，“2”-眶上，“3”-ICA 末端至 M1。尖端相对于每个转弯的内曲线被描述为“朝向”或“远离”。还分析了尖端“被卡住”的情况。
Z71 在绕过“转弯 1”时，尖端没有优先的成角方向，51%为“远离”，44%为“朝向”，p=0.54；“2”，46.5%为“远离”，53.5%为“朝向”，p=0.55；和“3”，43.7%为“远离”，46.5%为“朝向”，p=0.63。尖端在转弯 1 处没有被卡住。在 15.5%的操作中，尖端在“2”处被卡住。在转弯 2 处，“远离”的尖端被卡住的比例为 21%，而“朝向”的尖端被卡住的比例为 10.5%，p=0.22。Z71 在“3”处被卡住的比例为 4.7%。“远离”的尖端被卡住的比例为 6.5%，而“朝向”的尖端被卡住的比例为 3%，p=0.52。与使用其他导引导管相比，使用 Zoom 88（Z88）作为导引导管可能与 Z71 在“2”处的卡住率较低有关，Z88 为 9.3%，而其他为 25%，p=0.07。这也适用于转弯 3，Z88 为 0%，而其他为 11.1%，p=0.038。
Z71 在颈动脉虹吸内导航时，没有优先的成角尖端方向。尖端方向似乎不会显著影响导航。使用 Z88 作为导引导管有助于提高 Z71 在虹吸内的跟踪能力。
