Kadosh Chen Meir, Brauner Ran, Naftali Jonathan, Pardo Keshet, Barnea Rani, Findler Michael, Auriel Eitan, Raphaeli Guy
Department of Neurology, Rabin Medical Center, Petach Tikva, Israel.
Interventional Neuroradiology Unit, Rabin Medical Center, Petach Tikva, Israel.
Interv Neuroradiol. 2025 Jun 4:15910199251347776. doi: 10.1177/15910199251347776.
Background and purposeTo assess the safety and efficacy of Tigertriever 13 (T13) (one center experience) for mechanical thrombectomy (MT) in acute ischemic stroke (AIS) in patients with primary or secondary distal, medium-size vessel occlusions (DMVOs).MethodsWe performed a retrospective analysis of all consecutive AIS patients who underwent thrombectomy with T13 for DMVO (from 2018 until the present). Patient's characteristics were analyzed as well as procedural complications, angiographic (modified thrombolysis in cerebral infarction [mTICI]) score, and clinical outcomes (modified Rankin Scale [mRS]).ResultsOur cohort included 43 patients. Male predominance was noticed (60.5%), the median age was 71 years (interquartile range [IQR], 65-83), and 37.2% of patients received IV lytics prior to MT. Our cohort was divided into three sub-groups: (1) primary DMVO (17 patients, 39.5%), (2) secondary DMVO following large vessel occlusion (19 patients, 44.18%), and (3) DMVO related to the non-stroke endovascular procedure, such as aneurysm repair and carotid artery stenting (seven patients, 16.2%). Successful recanalization (mTICI 2b-3) was achieved in most of the patients (37/43, 86.04%). None of the patients have experienced symptomatic intracranial hemorrhage (ICH), and seven patients (16.3%) had asymptomatic ICH. Median mRS score was 3 at day 90 (IQR, 2-5), with 17 patients (39.5%) gained favorable outcome (mRS ≤ 2). Mortality was documented among 11.8% in primary DMVO and 10.52% in secondary DMVO.ConclusionsT13 for MT seems to be safe and effective for DMVO. Clinical outcomes and complications were in line with those described among patients with proximal occlusions. Although considered a remote target, it seems to be technically achievable with a reasonable outcome.
背景与目的
评估Tigertriever 13（T13）（单中心经验）用于急性缺血性卒中（AIS）患者原发性或继发性远端中等大小血管闭塞（DMVO）的机械取栓（MT）的安全性和有效性。
方法
我们对所有连续接受T13取栓治疗DMVO的AIS患者（从2018年至今）进行了回顾性分析。分析了患者的特征、手术并发症、血管造影（改良脑梗死溶栓[mTICI]）评分和临床结局（改良Rankin量表[mRS]）。
结果
我们的队列包括43例患者。男性占优势（60.5%），中位年龄为71岁（四分位间距[IQR]，65 - 83），37.2%的患者在MT前接受了静脉溶栓治疗。我们的队列分为三个亚组：（1）原发性DMVO（17例患者，39.5%），（2）大动脉闭塞后继发性DMVO（19例患者，44.18%），以及（3）与非卒中血管内手术相关的DMVO，如动脉瘤修复和颈动脉支架置入术（7例患者，16.2%）。大多数患者（37/43，86.04%）实现了成功再通（mTICI 2b - 3）。没有患者发生症状性颅内出血（ICH），7例患者（16.3%）有无症状ICH。90天时mRS评分中位数为3（IQR，2 - 5），17例患者（39.5%）获得良好结局（mRS≤2）。原发性DMVO患者的死亡率为11.8%，继发性DMVO患者的死亡率为10.52%。
结论
T13用于MT治疗DMVO似乎是安全有效的。临床结局和并发症与近端闭塞患者中描述的情况一致。尽管被认为是一个远端靶点，但在技术上似乎是可以实现的，且结局合理。
