학술논문
Feasibility of super-bore 0.088″ mechanical thrombectomy in M1 vessels smaller than 8 French: Experience in 20 consecutive cases.
Document Type
Academic Journal
Author
Campos JK; Department of Neurological Surgery, University of California Irvine, Orange, CA, USA.; Meyer BM; University of Arizona, College of Medicine, Tucson, AZ, USA.; Khan MW; Carondelet Neurological Institute, St. Joseph's Hospital, Tucson, AZ, USA.; Laghari FJ; Carondelet Neurological Institute, St. Joseph's Hospital, Tucson, AZ, USA.; Zarrin DA; University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.; Collard de Beaufort J; College of Arts and Science, Syracuse University, Syracuse, NY, USA.; Amin G; Carondelet Neurological Institute, St. Joseph's Hospital, Tucson, AZ, USA.; Golshani K; Department of Neurological Surgery, University of California Irvine, Orange, CA, USA.; Bender MT; Department of Neurosurgery, University of Rochester, Rochester, NY, USA.; Colby GP; Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA.; Lin LM; Carondelet Neurological Institute, St. Joseph's Hospital, Tucson, AZ, USA.; Coon AL; Carondelet Neurological Institute, St. Joseph's Hospital, Tucson, AZ, USA.
Source
Publisher: Sage Publications Country of Publication: United States NLM ID: 9602695 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2385-2011 (Electronic) Linking ISSN: 15910199 NLM ISO Abbreviation: Interv Neuroradiol Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Superbore 0.088″ catheters provide a platform for optimizing aspiration efficiency and flow control during stroke mechanical thrombectomy procedures. New superbore catheters have the distal flexibility necessary to navigate complex neurovascular anatomy while providing the proximal support of traditional 8F catheters. The safety and feasibility of Zoom 88™ superbore angled-tip catheters in the middle cerebral artery (MCA) segments smaller than the catheter diameter have not been previously described.
Methods: Twenty consecutive cases of acute MCA mechanical thrombectomy were retrospectively identified from the senior authors' prospectively maintained Institutional Review Board-approved database, in which the Zoom 88 (Imperative Care, Campbell, CA) catheter was successfully navigated to at least the M1 segment. Patient demographics, procedural details, and periprocedural information were analyzed. Rates and averages (standard errors) are generally reported.
Results: The average National Institutes of Health Stroke Scale at presentation and age were 15 ± 2 and 73 ± 3 years, respectively. The M1 and M2 occlusions were evenly distributed. The average M1 measurements before thrombectomy ranged from 2.36 ± 0.07 mm proximally to 2.00 ± 0.11 mm distally, and after thrombectomy, they ranged from 2.34 ± 0.07 mm proximally to 1.97 ± 0.10 mm distally. First-pass modified thrombolysis in cerebral infarction (mTICI) 2C/3 recanalization was achieved in 40% of cases, and final mTICI 2C/3 recanalization was achieved in 90% of cases. A single case of mild vasospasm was managed with verapamil. No hemorrhagic or periprocedural complications were noted.
Conclusion: Superbore 0.088″ catheters with flexible distal segments can be safely navigated to the MCA to augment mechanical thrombectomy even when the MCA segment is smaller than the catheter.
Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Alexander L. Coon is a consultant for Medtronic Neurovascular, MicroVention-Terumo, Stryker Neurovascular, Cerenovus, Rapid Medical, Avail MedSystems, Imperative Care, Deinde, InNeuroCo, Q'apel and a proctor for MicroVention-Termo, Stryker Neurovascular, and Medtronic Neurovascular. Li-Mei Lin is a proctor for Medtronic Neurovascular, Stryker Neurovascular, MicroVention-Terumo and a consultant for Medtronic Neurovascular, Stryker Neurovascular, MicroVention-Terumo, Rapid Medical, and Balt. Geoffrey P. Colby is a consultant for Medtronic Neurovascular, MicroVention-Terumo, Rapid Medical, Cerenovus, and Stryker Neurovascular. Matthew Bender is a proctor Stryker Neurovascular. All other authors have no conflict of interest. No author received financial support in conjunction with the generation of this submission.
Methods: Twenty consecutive cases of acute MCA mechanical thrombectomy were retrospectively identified from the senior authors' prospectively maintained Institutional Review Board-approved database, in which the Zoom 88 (Imperative Care, Campbell, CA) catheter was successfully navigated to at least the M1 segment. Patient demographics, procedural details, and periprocedural information were analyzed. Rates and averages (standard errors) are generally reported.
Results: The average National Institutes of Health Stroke Scale at presentation and age were 15 ± 2 and 73 ± 3 years, respectively. The M1 and M2 occlusions were evenly distributed. The average M1 measurements before thrombectomy ranged from 2.36 ± 0.07 mm proximally to 2.00 ± 0.11 mm distally, and after thrombectomy, they ranged from 2.34 ± 0.07 mm proximally to 1.97 ± 0.10 mm distally. First-pass modified thrombolysis in cerebral infarction (mTICI) 2C/3 recanalization was achieved in 40% of cases, and final mTICI 2C/3 recanalization was achieved in 90% of cases. A single case of mild vasospasm was managed with verapamil. No hemorrhagic or periprocedural complications were noted.
Conclusion: Superbore 0.088″ catheters with flexible distal segments can be safely navigated to the MCA to augment mechanical thrombectomy even when the MCA segment is smaller than the catheter.
Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Alexander L. Coon is a consultant for Medtronic Neurovascular, MicroVention-Terumo, Stryker Neurovascular, Cerenovus, Rapid Medical, Avail MedSystems, Imperative Care, Deinde, InNeuroCo, Q'apel and a proctor for MicroVention-Termo, Stryker Neurovascular, and Medtronic Neurovascular. Li-Mei Lin is a proctor for Medtronic Neurovascular, Stryker Neurovascular, MicroVention-Terumo and a consultant for Medtronic Neurovascular, Stryker Neurovascular, MicroVention-Terumo, Rapid Medical, and Balt. Geoffrey P. Colby is a consultant for Medtronic Neurovascular, MicroVention-Terumo, Rapid Medical, Cerenovus, and Stryker Neurovascular. Matthew Bender is a proctor Stryker Neurovascular. All other authors have no conflict of interest. No author received financial support in conjunction with the generation of this submission.