Novel Tenzing 7 Delivery Catheter for Thrombectomy in Acute Stroke: A Clinical Multicenter Experience

IF 2.1 Q3 CLINICAL NEUROLOGY
D. Tonetti, M. Bhattacharyya, M. Koneru, J. English, F. Settecase, Warren T. Kim, P. Patel, Ajith Thomas, T. Jovin, R. Hanel, V. Benalia, G. Cortez, A. Aghaebrahim, E. Sauvageau, M. Abdalkader, Thanh N. Nguyen, P. Klein, A. Dmytriw, Hamza Shaikh
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Abstract

Preliminary in vitro and early clinical experience of the Tenzing 7 delivery catheter demonstrated high success rates of aspiration catheter intracranial delivery with minimal complications. This study aimed to examine the efficacy, safety, and efficiency of the Tenzing 7 delivery catheter to deliver therapeutic devices in aspiration mechanical thrombectomy for acute ischemic strokes using clinical experience from multiple institutions. We performed a retrospective analysis of prospectively collected data from patients with acute ischemic stroke treated with aspiration mechanical thrombectomy using the Tenzing 7 delivery catheter between January 2020 and July 2022 at 6 high volume stroke centers. Primary efficacy outcome was success in aspiration catheter delivery to the face of the thrombus, and primary safety end point was rate of procedural complication. Of a total of 176 patients (mean age 70.1±14.9 years, 56.3% female, 89.2% middle cerebral artery occlusions), first‐pass effect (modified Thrombolysis in Cerebral Infarction score≥2B) was achieved in 90/166 (54.2%) successfully revascularized patients. Tenzing 7 delivered the aspiration catheter of choice to the site of occlusion in 95.9% of cases; the clot was not crossed with Tenzing 7 in 69% of cases. Successful recanalization (modified Thrombolysis in Cerebral Infarction score≥2B) was achieved in 94.9% of cases requiring a median of 1 pass (interquartile range 1–3). Nonflow limiting vessel dissection unrelated to Tenzing 7 occurred in 4 patients (2.3%), and intracranial vessel perforation unrelated to Tenzing 7 occurred in 4 cases (2.3%). This multicenter clinical experience using Tenzing 7 in mechanical thrombectomy demonstrated high rates of technical success and a modest complication rate, similar to the published rates of technical success with other thrombectomy techniques. The Tenzing 7 delivery catheter is effective and safe for the delivery of the aspiration catheter in patients undergoing thrombectomy for acute ischemic stroke.
新型Tenzing 7输尿管用于急性脑卒中取栓:临床多中心经验
Tenzing 7输送导管的初步体外和早期临床经验表明,抽吸导管颅内输送的成功率很高,并发症很小。本研究旨在利用多个机构的临床经验,检验Tenzing 7输送导管在急性缺血性中风抽吸机械血栓切除术中输送治疗装置的有效性、安全性和效率。我们对2020年1月至2022年7月期间在6个大容量卒中中心使用Tenzing 7输送导管接受抽吸机械血栓切除术的急性缺血性卒中患者的前瞻性收集数据进行了回顾性分析。主要疗效结果是成功地将抽吸导管输送到血栓表面,主要安全终点是手术并发症的发生率。在总共176名患者中(平均年龄70.1±14.9岁,56.3%为女性,89.2%为大脑中动脉闭塞),成功血运重建的患者中有90/166名(54.2%)达到了一次通过效果(改良脑梗死溶栓评分≥2B)。Tenzing 7在95.9%的病例中将所选择的抽吸导管输送到闭塞部位;在69%的病例中血栓没有与Tenzing7交叉。94.9%的病例需要中位1次通过(四分位间距1-3),成功再通(改良脑梗死溶栓评分≥2B)。4例患者(2.3%)发生了与Tenzing 7无关的非血流限制性血管夹层,4例患者发生了与Tenzing 7有关的颅内血管穿孔(2.3%)。使用Tenzing7进行机械血栓切除术的这一多中心临床经验表明,技术成功率高,并发症发生率适中,与其他血栓切除术的技术成功率相似。Tenzing 7输送导管对于急性缺血性卒中血栓切除患者的抽吸导管输送是有效和安全的。
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