Complete clot ingestion with cyclical ADAPT increases first-pass recanalization and reduces distal embolization
Complete clot ingestion with cyclical ADAPT increases first-pass recanalization and reduces distal embolization
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DOI：
10.1136/neurintsurg-2018-014625
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发表时间：
2019-09-01
影响因子：
4.8
通讯作者：
Chueh, Ju-Yu
中科院分区：
文献类型：
--
作者：
Arslanian, Rose A.;Marosfoi, Miklos;Chueh, Ju-Yu
背景越来越多的证据表明，机械取栓术中首次通过完全再通与急诊大血管闭塞患者更好的临床结果相关。我们假设吸入达到完全的血块摄取导致更高的第一次成功再通，并定量减少远端栓塞。方法将患者特异性脑血管复制品与血流环连接。用凝块类似物闭塞大脑中动脉。自变量为抽吸导管直径（0.054-0.088英寸）和抽吸方式（静态与周期性）。结果测量是血块完全摄取的一次通过率，再通的程度和远端栓塞的颗粒大小分布。结果所有抽吸导管均顺利导航至闭塞处。吸入性取栓术中完全摄取血块，每次实验都能首次完全再通，而部分摄取的实验只有21%能实现(P
Background Evidence is mounting that first-pass complete recanalization during mechanical thrombectomy is associated with better clinical outcomes in patients presenting with an emergent large vessel occlusion. We hypothesize that aspiration achieving complete clot ingestion results in higher first-pass successful recanalization with quantitative reduction in distal emboli.Methods A patient-specific cerebrovascular replica was connected to a flow loop. Occlusion of the middle cerebral artery was achieved with clot analogs. Independent variables were the diameter of the aspiration catheter (0.054-0.088in) and aspiration pattern (static versus cyclical). Outcome measures were the first-pass rates of complete clot ingestion, the extent of recanalization, and the particle-size distribution of distal emboli.Results All aspiration catheters were successfully navigated to the occlusion. Complete clot ingestion during aspiration thrombectomy resulted in first-pass complete recanalization in every experiment, only achieved in 21% of experiments with partial ingestion (P