Factors related to vessel displacement due to stent retriever retraction: An in vitro study

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology Pub Date : 2024-04-17 DOI:10.1016/j.neurad.2024.04.002

Hiroyuki Ikeda, Masanori Kinosada, Minami Uezato, Yoshitaka Kurosaki, Masaki Chin, Sen Yamagata

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引用次数: 0

Abstract

Background

Thrombectomy with a stent retriever (SR) may lead to intracranial hemorrhage due to vessel displacement. We aimed to explore factors related to vessel displacement using an in vitro vessel model.

Methods

A vessel model mimicking two-dimensional left internal carotid angiography findings was used in this study. Six SR types (Solitaire 3 × 40, 4 × 40, and 6 × 40; Embotrap 5 × 37; Trevo 4 × 41; and Tron 4 × 40) were fully deployed in the M2 ascending, M2 bend, or M1 horizontal portion. Subsequently, the SR was retracted, and the vessel displacement, maximum SR retraction force, and angle of the M2 bend portion were measured. A total of 180 SR retraction experiments were conducted using 6 SR types at 3 deployment positions with 10 repetitions each.

Results

The mean maximum distance of vessel displacement for Embotrap Ⅲ 5 × 37 (6.4 ± 3.5 mm, n = 30) was significantly longer than that for the other five SR types (p = 0.029 for Solitaire 6 × 40 and p < 0.001 for the others, respectively). Vessel displacement was significantly longer in the M2 ascending portion group (5.4 ± 3.0 mm, n = 60) than in the M2 bend portion group (3.3 ± 1.6 mm, n = 60) (p < 0.001) and it was significantly longer in the M2 bend portion group than in the M1 horizontal portion group (1.1 ± 0.7 mm, n = 60) (p < 0.001). A positive correlation existed between the mean maximum SR retraction force or mean angle of the M2 bend portion due to SR retraction (i.e., vessel straightening) and the mean maximum distance of vessel displacement (r = 0.90, p < 0.001; r = 0.90, p < 0.001, respectively).

Conclusions

Vessel displacement varied with the SR type, size, and deployment position. Moreover, vessel displacement correlated with the SR retraction force or vessel straightening of the M2 bend portion.

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支架回缩器回缩导致血管移位的相关因素：体外研究

使用支架回流器（SR）进行血栓清除术可能会因血管移位而导致颅内出血。我们旨在利用体外血管模型探讨与血管移位有关的因素。本研究使用了一个模仿二维左侧颈内动脉造影结果的血管模型。六种类型的 SR（Solitaire 3 × 40、4 × 40 和 6 × 40；Embotrap 5 × 37；Trevo 4 × 41 和 Tron 4 × 40）在 M2 升支、M2 弯支或 M1 水平部分完全展开。随后，SR 回缩，并测量血管位移、最大 SR 回缩力和 M2 弯曲部分的角度。在 3 个部署位置使用 6 种 SR 进行了共计 180 次 SR 回缩实验，每次重复 10 次。Embotrap Ⅲ 5 × 37 的血管位移平均最大距离（6.4 ± 3.5 mm，= 30）明显长于其他五种 SR 类型（Solitaire 6 × 40 = 0.029，其他类型小于 0.001）。M2 上升部分组的血管移位（5.4 ± 3.0 mm，= 60）明显长于 M2 弯曲部分组（3.3 ± 1.6 mm，= 60）（< 0.001），M2 弯曲部分组的血管移位明显长于 M1 水平部分组（1.1 ± 0.7 mm，= 60）（< 0.001）。平均最大 SR 回缩力或因 SR 回缩（即血管拉直）造成的 M2 弯曲部分的平均角度与平均最大血管移位距离之间存在正相关（分别为 = 0.90，< 0.001；= 0.90，< 0.001）。血管位移随 SR 类型、大小和部署位置而变化。此外，血管位移与 SR 回缩力或 M2 弯曲部分的血管伸直度相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuroradiology 医学-核医学

CiteScore

6.10

自引率

5.70%

发文量

142

审稿时长

6-12 weeks

期刊介绍： The Journal of Neuroradiology is a peer-reviewed journal, publishing worldwide clinical and basic research in the field of diagnostic and Interventional neuroradiology, translational and molecular neuroimaging, and artificial intelligence in neuroradiology. The Journal of Neuroradiology considers for publication articles, reviews, technical notes and letters to the editors (correspondence section), provided that the methodology and scientific content are of high quality, and that the results will have substantial clinical impact and/or physiological importance.

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