Hassan Ameer E, Haussen Diogo, Al-Bayati Alhamza, Dolia Jaydevsinh, Grossberg Jonathan A, Rehman Alman, Miller Samantha, Colasurdo Marco, Priest Ryan, Zaidi Syed Syed F, Jumaa Mouhammad A, Bender Matthew, Bhalla Tarun, Herbert Ryan, Matouk Charles, Arthur Adam S, Nogueira Raul G
Clinical Research Department, Valley Baptist Medical Center, Harlingen, TX, USA.
Neuroscience Department, University of Texas Rio Grande Valley - Valley Baptist Medical Center, Harlingen, TX, USA.
Interv Neuroradiol. 2025 Jul 29:15910199251350180. doi: 10.1177/15910199251350180.
BackgroundAspiration is rapidly becoming the first-line strategy for mechanical thrombectomy for LVOs. Superbore aspiration catheters (lumen ≥ 0.088") have been suggested to provide advantages over conventional aspiration including improved recanalization and reduced distal emboli owing to distal flow control. The objective of this study was to assess the technical feasibility and safety of contact aspiration using the novel Millipede Superbore catheter and the Millipede catheter.MethodsA retrospective analysis of consecutive cases using the Millipede Superbore catheter as first-line for the treatment of large vessel occlusions was conducted. Key outcome parameters assessed were navigation to target occlusion, recanalization success, procedure-related complications, NIHSS, and symptomatic intracranial hemorrhage at 24 h.Results26 patients were treated using Millipede catheters. The first-pass effect, defined as mTICI ≥ 2c reperfusion using contact aspiration, was achieved in 69% of cases. mTICI ≥ 2c at final angiography was obtained in 88% of cases. Contact aspiration alone was used in 92% of cases. No catheter-related complications, such as dissections or perforations, or embolization to new territory was reported. sICH did not occur in any of the cases. The median drop in NIHSS at 24 h was eight points.ConclusionsIn the majority of cases, aspiration using the Millipede catheter results in excellent recanalization with one pass, with an excellent safety profile. These data suggest that aspiration thrombectomy using the Millipede Superbore catheter is feasible and safe. A large prospective trial of Millipede for aspiration thrombectomy is underway.
背景
抽吸术正迅速成为左心室闭塞机械取栓的一线策略。有人提出，超大腔抽吸导管（管腔≥0.088英寸）相较于传统抽吸具有优势，包括改善再通以及由于远端血流控制减少远端栓塞。本研究的目的是评估使用新型千足虫超大腔导管和千足虫导管进行接触抽吸的技术可行性和安全性。
方法
对连续使用千足虫超大腔导管作为治疗大血管闭塞一线方法的病例进行回顾性分析。评估的关键结局参数包括到达目标闭塞部位的导航情况、再通成功率、与手术相关的并发症、美国国立卫生研究院卒中量表（NIHSS）评分以及24小时时的症状性颅内出血情况。
结果
26例患者使用千足虫导管进行了治疗。69%的病例实现了首次通过效应，即使用接触抽吸达到改良脑梗死溶栓分级（mTICI）≥2c级再灌注。88%的病例在最终血管造影时达到mTICI≥2c级。92%的病例仅使用了接触抽吸。未报告与导管相关的并发症，如夹层或穿孔，或新区域的栓塞。所有病例均未发生症状性颅内出血（sICH）。24小时时NIHSS评分的中位数下降了8分。
结论
在大多数病例中，使用千足虫导管进行抽吸一次即可实现良好的再通，且安全性良好。这些数据表明，使用千足虫超大腔导管进行抽吸取栓是可行且安全的。一项关于千足虫用于抽吸取栓的大型前瞻性试验正在进行中。
