Zoom71 navigation: Does tip orientation matter?

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2024-10-30 DOI:10.1016/j.clineuro.2024.108625

Miguel S. Litao , Brent Flusty , Mohamad Ezzeldin , Adam Delora , Omar Tanweer , Eytan Raz , Ryan T. Kellogg , Jan-Karl Burkhardt , Mohamed Salem , Brian Jankowitz

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引用次数: 0

Abstract

Background

Aspiration thrombectomy is one of the mainstays for stroke interventions. The Zoom 71 (Z71) aspiration catheter is unique with its angled tip. This study describes the orientation of the angled tip as it is navigated around the carotid siphon in relation to trackability.

Method

Prospectively collected cases involving large vessel occlusions of the anterior circulation intervened upon using the Z71 were retrospectively analyzed. 71 passes in 50 patients were analyzed with respect to Z71 tip orientation. 3 anatomical “turns” were defined as follows: “1”: proximal cavernous, “2”- ophthalmic turn, and “3”-ICA terminus to M1. The tip was described as “Toward” Vs “Away” with respect to the inner curve of each turn. The tip getting “caught” was also analyzed.

Results

There was no preferential angled tip orientation of the Z71 as it was navigated around “Turn 1”, 51 % “Away” vs 44 % “Toward”, p= 0.54; “2”, 46.5 % “Away” vs 53.5 % “Toward”, p= 0.55; and “3”, 43.7 % “Away” vs 46.5 % “Toward”, p=0.63. The tip was not caught in Turn 1. It was caught up in “2” in 15.5 % of passes. “Away” at “2” got caught up in 21 % of passes vs 10.5 % for “Toward”, p= 0.22. Z71 got caught up in “3” in 4.7 % of passes. “Away” was associated with getting caught in 6.5 % of passes vs 3 % for “Toward”, p=0.52. Zoom 88 (Z88) usage as guide catheter may be associated with Z71 getting caught less in “2” compared to “Others”, 9.3 % for Z88 vs 25 %, p= 0.07. This also applied to Turn 3, 0 % for Z88 vs 11.1 %, p=0.038.

Conclusion

There is no preferential angled tip orientation of the Z71 as it navigates around the carotid siphon. The tip orientation does not appear to significantly affect navigation. Usage of Z88 as guide catheter helps with Z71 trackability around the siphon.

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Zoom71 导航：提示方向重要吗？

背景：抽吸血栓切除术是中风介入治疗的主要方法之一。Zoom 71 (Z71) 抽吸导管的独特之处在于其倾斜的尖端。本研究描述了倾斜顶端在颈动脉虹吸管内航行时的方向与可追踪性的关系：方法：对前瞻性收集的使用 Z71 进行干预的前循环大血管闭塞病例进行回顾性分析。对 50 名患者的 71 次手术进行了 Z71 尖端方向分析。3 个解剖学 "转向 "定义如下：1"：近端海绵体，"2"-眼部转向，"3"-ICA 终点至 M1。相对于每个弯道的内侧曲线，尖端被描述为 "朝向 "或 "远离"。同时还分析了尖端被 "夹住 "的情况：结果：在绕过 "1 号弯 "时，Z71 的尖端方向没有偏好的角度，"远离 "的比例为 51%，"朝向 "的比例为 44%，P=0.54；"2 号弯"，"远离 "的比例为 46.5%，"朝向 "的比例为 53.5%，P=0.55；"3 号弯"，"远离 "的比例为 43.7%，"朝向 "的比例为 46.5%，P=0.63。在 "第 1 个转弯 "中，没有发现提示。在 "2 "弯，有 15.5 % 的车辆被卷入。在 "2 "弯 "远离 "时，有 21% 的通行被卡住，而 "靠近 "时为 10.5%，P=0.22。Z71 在 "3 "处被追上的比例为 4.7%。6.5%的传球与 "Away "有关，而 "Toward "为 3%，P=0.52。与 "其他 "相比，使用 Zoom 88（Z88）作为引导导管可能与 Z71 在 "2 "中被夹住的比例较低有关，Z88 为 9.3%，而 Z71 为 25%，P=0.07。这也适用于第 3 个弯，Z88 为 0% vs 11.1%，p=0.038：Z71在绕颈动脉虹吸管航行时，其尖端方向没有偏好的角度。尖端方向似乎不会对导航产生重大影响。使用 Z88 作为导引导管有助于 Z71 在虹吸管周围的追踪。

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

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.