Limaye Kaustubh, Al Kasab Sami, Dolia Jaidevsinh, Ezzeldin Mohamad, Duarte Daniel Vela, Doss Vinodh, Lahoti Sourabh, Hasan David, Spiotta Alejandro, Asi Khaled, Saini Vasu, Mehta Tapan, Hassan Ameer, Haussen Diogo, Yavagal Dileep, Jones Jesse, Tanweer Omar, Brinjikji Waleed
Department of Neurology, Neurological Surgery and Radiology, Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Neurology and Neurosurgery, Medical University of South Carolina, Charleston, SC, USA.
Interv Neuroradiol. 2024 Dec 18:15910199241308328. doi: 10.1177/15910199241308328.
Mechanical thrombectomy (MT) has become the standard of care for treatment of acute ischemic stroke secondary to large vessel occlusion up to 24 h from the last known normal time. With ADAPT and SOLUMBRA techniques, classically, a large bore aspiration catheter is delivered over a microcatheter and microwire crossing the clot to perform thrombectomy. Recently, a novel macrowire (Colossus 035 in.) has been introduced as a potential alternative to the use of microwire-microcatheter to allow the delivery of the aspiration catheter (ID = 0.070 in. up to 0.088 in.) over a macrowire alone.
To test the feasibility of delivering an aspiration catheter to clot interface over a macrowire alone.
A retrospective evaluation of prospectively maintained Macrowire for Intracranial Thrombectomy (MINT) Registry where this novel technique was utilized for thrombectomy. Consecutive patients undergoing MT using the MINT technique were included. We collected baseline demographics, imaging and clinical characteristics, rate of procedural success, conversion to traditional MT, and complications.
Fifty consecutive patients were recruited during the initial 4 months of the larger study duration. The aspiration catheter was able to be advanced to the clot interface successfully in 46/50 (92%) using the MINT technique. Median time from vascular access to the first pass was 11.30 min (IQR = 7.45-14.30 min) and successful thrombectomy was 14 min (IQR = 10-22.15). The modified first-pass effect with this procedure was 71%. One vasospasm was reported as a procedural complication.
MINT is safe and feasible for large vessel occlusion recanalization based on our initial clinical experience in this multicenter study.
机械取栓术（MT）已成为治疗距最后正常时间长达24小时的大血管闭塞继发急性缺血性卒中的标准治疗方法。传统上，采用ADAPT和SOLUMBRA技术时，大口径抽吸导管通过微导管和微导丝越过血栓进行取栓。最近，一种新型的大导丝（0.035英寸的巨像导丝）已被引入，作为使用微导丝-微导管的潜在替代方案，以允许仅通过大导丝输送抽吸导管（内径为0.070英寸至0.088英寸）。
测试仅通过大导丝将抽吸导管输送至血栓界面的可行性。
对前瞻性维护的颅内取栓大导丝（MINT）注册研究进行回顾性评估，该新技术用于取栓。纳入连续使用MINT技术进行MT的患者。我们收集了基线人口统计学、影像学和临床特征、手术成功率、转换为传统MT的情况以及并发症。
在更大研究期间的最初4个月内连续招募了50例患者。使用MINT技术，46/50（92%）的抽吸导管能够成功推进至血栓界面。从血管穿刺到首次通过的中位时间为11.30分钟（四分位间距[IQR]=7.45-14.30分钟），成功取栓时间为14分钟（IQR=10-22.15）。该手术的改良首次通过效果为71%。报告了1例血管痉挛作为手术并发症。
基于我们在这项多中心研究中的初步临床经验，MINT对于大血管闭塞再通是安全可行的。
