Comparative in vitro study of five mechanical embolectomy systems: effectiveness of clot removal and risk of distal embolization
Comparative in vitro study of five mechanical embolectomy systems: effectiveness of clot removal and risk of distal embolization
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DOI：
10.1007/s00234-007-0297-y
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发表时间：
2008-01-01
期刊：
影响因子：
2.8
通讯作者：
Henkes, Hans
中科院分区：
文献类型：
--
作者：
Liebig, Thomas;Reinartz, Joeg;Henkes, Hans
介绍我们报告了一项体外研究，比较凝块清除和凝块破碎的有效性的五个取栓systems.Methods的流动模型栓塞新鲜和旧的血栓，闭塞内径2-5毫米模拟颈内动脉（伊卡），基底动脉（BA）和大脑中动脉（MCA）分支闭塞。使用5种取栓系统进行栓子切除术：CATCH（Balt）、Merci取栓器（Concentric）、InTime和Attracter（Boston Scientific）和Phenox凝块取栓器（Phenox）。凝块清除和证据和类型的血栓粉碎和远端栓塞recorded.Results没有明显的差异归因于血栓年龄。Merci、CATCH和Phenox取栓器同样能够动员和清除血栓，但一个特别坚硬的血栓除外。在血栓破碎和远端栓塞方面存在显著差异。所有器械在穿透和回收过程中均产生了微碎片和大碎片。Phenox凝块回收器能够过滤碎片。InTime和Attracter装置未能收回血栓在这个模型中，并实现部分清除，最好的趋势，对血栓的位移和fractionation.Conclusion在一定范围内，实验装置是适当的，用于产生直径2-5 mm的各种长度的闭塞，模拟伊卡，BA和MCA血栓栓塞。在该模型中，血栓动员似乎较少依赖于回收系统的个体设计，而不是血栓破碎。然而，防止远端栓塞的能力在很大程度上取决于血栓切除术器械捕获器械取出过程中产生的碎片的能力。
Introduction We report an in vitro study comparing the effectiveness of clot removal and clot fragmentation of five embolectomy systems.Methods A flow model was embolized with fresh and old thrombi, occluding an inner diameter of 2-5 mm simulating internal carotid artery (ICA), basilar artery (BA) and middle cerebral artery (MCA) branch occlusion. Embolectomy was performed using five retrieval systems: CATCH (Balt), Merci retriever (Concentric), InTime and Attracter (Boston Scientific), and the Phenox Clot Retriever (Phenox). Clot removal and evidence and type of thrombus fragmentation and distal embolization were recorded.Results There were no observable differences attributable to thrombus age. The Merci, CATCH and Phenox Clot Retriever were equally able to mobilize and remove thrombi with the exception of one particularly firm clot. There were marked differences in terms of thrombus fragmentation and distal embolization. All devices produced micro- and macrofragments during penetration and retrieval. The Phenox Clot Retriever was able to filter fragments. The InTime and Attracter devices failed to retrieve thrombi in this model and achieved partial removal at best with a tendency towards thrombus displacement and fragmentation.Conclusion Within limits, the experimental setup was appropriate for generating occlusions of diameter 2-5 mm of various lengths, simulating ICA, BA and MCA thromboembolism. In this model, thrombus mobilization appeared to be less dependent upon the individual design of the retrieval system than on thrombus fragmentation. The ability to prevent distal embolization is, however, strongly dependent on the ability of a thrombectomy device to capture fragments that are generated during removal of the device.