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高支撑预塑形引导导管(SEL-E和岩手系列)在神经血管内治疗中的应用。

Utilization of high-support pre-shaped guiding catheter (SEL-E and IWATE series) in neuroendovascular treatment.

作者信息

Takikawa Kohei, Kimura Naoto, Nakajima Satsuki, Sonoda Takuji, Yokosawa Michiko, Sugawara Takayuki, Kikuchi Takahiko

机构信息

Department of Neurology, Iwate Prefectural Central Hospital, Morioka, Japan.

Department of Neurosurgery, Iwate Prefectural Central Hospital, Morioka, Japan.

出版信息

Interv Neuroradiol. 2025 Jun 2:15910199251345629. doi: 10.1177/15910199251345629.

Abstract

BackgroundGuiding catheters (GCs) are crucial platforms for neuroendovascular procedures. High-support pre-shaped guiding catheters (HPGCs) were designed to address access difficulties in complex anatomies. Given its versatility in neuroendovascular treatment, we report our single-center experience with the HPGCs.MethodsA single-center retrospective analysis was conducted on 154 neuroendovascular procedures using the HPGCs between January 2017 and February 2024. The HPGCs include three models: SEL-E, IWATE, and IWATE-L. The cases were categorized into three scenarios: addressing access failure, serving as a platform for posterior circulation interventions, and supporting angioplasty for neck-thoracic lesions. Data on procedural success, complications, and anatomical characteristics were collected.ResultsSuccessful access was achieved in 92.4% of access failure cases (n = 79). Successful recanalization was achieved in 60.5% of thrombectomy cases, with a median patient age of 89 years and complex vascular anatomies involving a type 3 aorta in 94.2% of cases. For posterior circulation procedures (n = 67), the treatment success rate was 97.0%, utilizing a strategy that combined the HPGCs with intermediate catheters to prevent large-bore GCs from entering the vertebral artery. In angioplasty for neck-thoracic lesions (n = 8), technical success was achieved in 75% of patients.ConclusionsThe pre-shaped, high-support features of the HPGCs demonstrated effectiveness and safety in access failure cases while enabling broader utilization in posterior circulation and neck-thoracic lesion procedures.

摘要

背景

引导导管(GCs)是神经血管内介入手术的关键平台。高支撑预塑形引导导管(HPGCs)旨在解决复杂解剖结构中的通路困难问题。鉴于其在神经血管内治疗中的多功能性,我们报告我们单中心使用HPGCs的经验。

方法

对2017年1月至2024年2月期间使用HPGCs进行的154例神经血管内介入手术进行单中心回顾性分析。HPGCs包括三种型号:SEL-E、岩手型和岩手-L型。病例分为三种情况:解决通路失败、作为后循环介入的平台以及支持颈部-胸部病变的血管成形术。收集手术成功率、并发症和解剖特征的数据。

结果

在92.4%的通路失败病例(n = 79)中成功实现了通路建立。在60.5%的取栓病例中成功实现了再通,患者中位年龄为89岁,94.2%的病例存在复杂血管解剖结构,包括3型主动脉。对于后循环手术(n = 67),治疗成功率为97.0%,采用了将HPGCs与中间导管相结合的策略,以防止大口径GCs进入椎动脉。在颈部-胸部病变的血管成形术(n = 8)中,75%的患者取得了技术成功。

结论

HPGCs的预塑形、高支撑特性在通路失败病例中显示出有效性和安全性,同时在后循环和颈部-胸部病变手术中具有更广泛的应用。

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