Interventional Neuroradiology最新文献

{"title":"Histotripsy: A novel non-invasive ultrasound technology for precision thrombolysis in acute ischemic stroke management.","authors":"Ameer E Hassan, Thomas Dreyer, Yousef Khalili","doi":"10.1177/15910199251347838","DOIUrl":"10.1177/15910199251347838","url":null,"abstract":"<p><p>BackgroundStroke remains a major cause of morbidity and mortality worldwide. Traditional treatments for ischemic stroke such as mechanical thrombectomy and pharmacological thrombolysis are often less effective or inaccessible for certain patient populations, particularly those with delayed hospital arrival, contraindications to thrombolytics, or in regions with limited access to endovascular care. This study investigates the feasibility of using histotripsy, a non-invasive ultrasound technology, to precisely liquefy thrombi in an artificial experimental setup.MethodsClot analogs were introduced into sample tubes, and focused ultrasound was applied using optimized parameters, including pulses per burst, repetition rates, and output amplitudes. These parameters were systematically adjusted to determine the most effective settings for clot ablation, with a focus on maximizing clot liquefaction while minimizing residual fragments.ResultsHistotripsy achieved complete clot liquefaction within 60-120 s at a repetition rate of 100  Hz, with 1000 pulses per burst and an output amplitude of 100%. The procedure effectively disintegrated soft (red blood cell-rich) clots, leaving minimal residual fragments (<250 microns). However, dense fibrin-rich clots and anatomical barriers like bone presented challenges, suggesting the need for further optimization.ConclusionsThis proof-of-concept study demonstrates the potential of histotripsy as a non-invasive, rapid, and targeted approach for clot removal in stroke management.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251347838"},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid artery stenting using CASPER has a lower incidence of ischemic complications compared to Carotid WALLSTENT, but there is no significant difference in postoperative restenosis.","authors":"Takashi Fujii, Shuta Maehara, Yoshimasa Fukui, Kousei Maruyama, Kosuke Takigawa, Noriaki Tashiro, Hidetoshi Matsukawa, Yoshiya Hashiguchi, Masanobu Yasumoto, Masahiro Yasaka, Hiroshi Aikawa, Yoshinori Go, Kiyoshi Kazekawa","doi":"10.1177/15910199251347774","DOIUrl":"10.1177/15910199251347774","url":null,"abstract":"<p><p>BackgroundThe usefulness of CASPER, a second-generation carotid stent, for carotid artery stenosis is becoming increasingly clear. However, few studies have directly compared treatment outcomes with those of the first-generation Carotid WALLSTENT. This study aimed to compare the outcomes of carotid artery stenting using CASPER and Carotid WALLSTENT for carotid artery stenosis performed at a single institution.MethodsThis retrospective study included 117 consecutive cases (Carotid WALLSTENT, 58 cases; CASPER, 59 cases) where carotid stent placement was performed for internal carotid artery stenosis between 2020 and 2021. Patient background, the presence or absence of ischemic complications as postoperative treatment outcomes, and the presence or absence of restenosis were extracted from the electronic medical records, and the results were compared between the Carotid WALLSTENT and the CASPER treatment groups.ResultsWhen comparing ischemic complications between the two groups, the treatment outcomes in the CASPER group were significantly better (Carotid WALLSTENT vs. CASPER: 6 (10.3%) vs. 2 (3.4%), respectively, <i>p</i> = 0.039). However, no significant difference in postoperative restenosis was observed between the two groups. Multivariate analysis revealed that using CASPER significantly reduced ischemic complications (odds ratio: 0.101, 95% confidence interval: 0.0117-0.878).ConclusionsCarotid artery stenting using CASPER for internal carotid artery stenosis was associated with fewer ischemic complications than that with the Carotid WALLSTENT. No differences in treatment outcomes were observed with CASPER and Carotid WALLSTENT in terms of postoperative restenosis.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251347774"},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"pEGASUS HPC stent pusher-assisted catheterization (PAC) of nonruptured cerebral aneurysms: Safety and efficacy.","authors":"Bayan Alhaj Moustafa, Ali Khanafer, Mete Dadak, Christopher Nimsky, Alexander Grote, Abdallah Aburub, Hans Henkes, André Kemmling, Mohammad Almohammad","doi":"10.1177/15910199251348005","DOIUrl":"10.1177/15910199251348005","url":null,"abstract":"<p><p><b>Objectives:</b> To investigate the safety and efficacy of using the pEGASUS HPC stent pusher instead of a microwire for catheterization of nonruptured cerebral aneurysms during stent-assisted coiling. <b>Methods:</b> In this multicenter retrospective study (July 2021-June 2024), 107 patients with 118 incidental nonruptured cerebral aneurysms underwent stent-assisted coiling using pEGASUS HPC stents. Based on the catheterization technique, cases were assigned to either the microwire-assisted catheterization (MAC, n = 58) or the stent pusher-assisted catheterization (PAC, n = 60) group. Clinical and procedural data were analyzed to compare safety and efficacy, focusing on success rates, required catheterization time, complications, and adverse events. <b>Results:</b> The cohort (mean age 59 ± 13.2 years; 52.3% female). In the MAC group, aneurysm catheterization was successful in all cases (100%), with one procedure-related perforation caused by the microwire (1.7%). In contrast, the PAC group achieved a slightly lower success rate of 95% (57/60), but no perforations were observed. The mean catheterization time was significantly shorter in the PAC group (0.67 ± 0.24 minutes) compared to the MAC group (4.43 ± 0.59 minutes), demonstrating that PAC is approximately seven times faster. No other relevant complications were reported. <b>Conclusion:</b> PAC with the pEGASUS HPC stent pusher appears safe and effective for catheterizing nonruptured cerebral aneurysms, with high success, no perforations, and significantly shorter catheterization time. Larger prospective studies are needed to confirm these results.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251348005"},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radial access with the Piraeus 7Fr 87 NeuGlide catheter: A single center study of 40 patients.","authors":"R Chase Ransom, Lorenzo Rinaldo, Harry Cloft, Giuseppe Lanzino, Waleed Brinjikji","doi":"10.1177/15910199251345037","DOIUrl":"10.1177/15910199251345037","url":null,"abstract":"<p><p>BackgroundThere has been growing interest in transradial procedures over the past decade due to substantial reductions in access site complications as well as improved patient recovery. While several radial-specific neurovascular catheters have come to market, all catheters that are compatible with a 7Fr sheath have small inner diameters (IDs) (0.079″-0.082″), which can limit use of modern intermediate catheters. while larger-ID catheters cannot be used with a radial sheath resulting in complications related to radial artery spasm and entrapment. We report our results using a novel 7Fr-sheath-compatible radial guide catheter with an 0.087″ ID (Piraeus 7Fr 87 NeuGlide catheter) for neurovascular procedures.MethodsThis is a single center retrospective case series of patients undergoing transarterial transradial neuroendovascular procedures using the Piraeus 7Fr 87 NeuGlide catheter. The primary outcome was delivery of the catheter to the target vessel and successful completion of the procedure without the need to convert to femoral access or an alternative guide. Descriptive statistics are reported.ResultsForty patients were included. The most common procedure was middle meningeal artery embolization followed by aneurysm embolization. And 97.5% of procedures were completed successfully without conversion to femoral access; 75% were completed without the need of an intermediate guide catheter. One procedure required conversion to femoral access. There were no access site or neurological complications.ConclusionThe Piraeus 7Fr 87 NeuGlide catheter is both safe and effective for neurovascular procedures. The larger ID and 7Fr compatible outer diameter allows for the use of standard 5Fr and 6Fr intermediate/aspiration catheters.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251345037"},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring artery diameter in rabbit angiograms for neurovascular disease modeling applications and device testing.","authors":"Yasmine Khan, Jack Franklin, Jonathan Cortese, Esref Alperen Bayraktar, Alexander A Oliver, Yong-Hong Ding, Sarah Lortscher, Waleed Brinjikji, Ramanathan Kadirvel, David F Kallmes","doi":"10.1177/15910199251347398","DOIUrl":"10.1177/15910199251347398","url":null,"abstract":"<p><p>Background and purposeNew Zealand White Rabbits are a useful preclinical model for neurovascular research. Inducing right common carotid artery aneurysms in New Zealand White Rabbits gives researchers the ability to test neurovascular devices in vivo. This study takes advantage of archived angiograms to obtain vascular measurements of interest for future research in rabbit models.MethodsRabbit angiograms from endovascular studies conducted in-house between 2005 and 2024 were analyzed using ImageJ at points of interest along the thoracic and abdominal aorta. Using scale references, the diameters of various New Zealand White Rabbit (2.5-3.5 kg) arteries were measured for aneurysm models and controls. Anatomic vascular variations were categorized and recorded.ResultsMeasurable artery diameters at 39 points of interest were recorded for 170 female New Zealand White Rabbits. Type 1 vascular anatomy was the most common rabbit aortic arch, characterizing 85% of identifiable rabbit anatomies in this study.ConclusionBy making these measurements available, this study simplifies future neurovascular studies, allowing for vasculature to be selected by size depending on the application. Additionally, the study offers insight into the relationship between elastase-induced aneurysms and surrounding vasculature size and draws size comparisons between some key arteries of interest.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251347398"},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of FD-HPC in Ruptured and Unruptured Aneurysms, the Italian Dataset (RUAID): Preliminary results on feasibility and safety.","authors":"Elisa Ciceri, Emilio Lozupone, Matteo Milani, Mariangela Piano, Valentina Caldiera, Alessio Vitiello, Mario Muto, Flavio Giordano, Marco Erta, Simone Comelli, Paolo Nuzzi, Ignazio Divenuto, Carmelo Stanca, Fabrizio Venturi, Giuseppe Romano, Andrea Boghi, Chiara Comelli, Adriana Paladini, Alfredo Pauciulo, Paolo Remida, Mirko Patassini, Domenico Sergio Zimatore, Raffaella Messina, Guglielmo Pero, Giuseppe Faragò, Luca Quilici, Giuliano Gola, Ivan Gallesio, Massimiliano Natrella, Carmine Sicignano, Vincenzo D'agostino, Andrea Giorgianni, Claudio Chirico, Giuseppe Maria Ernesto La Tessa, Raffaele Augelli, Mauro Plebani, Anna Bersano, Giuseppe Ganci, Chiara Riccietti","doi":"10.1177/15910199251341643","DOIUrl":"10.1177/15910199251341643","url":null,"abstract":"<p><p>BackgroundThe introduction of flow diverters (FDs) has revolutionized the treatment of complex intracranial aneurysms; subsequent surface modifications have extended their indications to ruptured, bifurcation, and distal aneurysms. The aim of this study is to assess the real-world feasibility and safety of HPC surface-modified devices in the treatment of ruptured and unruptured aneurysms.MethodsThis independent, multicenter, prospective observational study evaluated the outcomes of patients treated with implanted Phenox p64 or p48 MW-HPC-FDs between 2020 and 2022. The sub-analysis of the procedures, complications (clinical and technical), and additional treatment requirements assessed the devices' feasibility and safety in the peri-procedural period.ResultsOne hundred and forty aneurysms (35% ruptured and 65% unruptured) were treated in 140 patients (37 females and 103 males) using 153 HPC-FDs (111 p64 and 42 p48): 100 aneurysms were saccular (71%), 22 dissecting (16%), 13 fusiform (9%), and five blister-like (3.6%). The successful deployment rate was 97.9%. The overall peri-procedural mortality rate was 9%, including three device-related deaths (2.2%); the overall morbidity rate was 12.1% (6.4% severe, 3.6% mild, and 2.1% asymptomatic adverse events); 4.4% of the clinical adverse events were certainly device related, and 2.2% were probably device related.ConclusionsThe use of p64 and p48 HPC-FDs is highly feasible and acceptably safe, although further data are needed to assess the impact of the coating on safety in emergency and elective procedures.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251341643"},"PeriodicalIF":1.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of general anesthesia on outcomes after anterior circulation mechanical thrombectomy: Results from the prospective international ASSIST registry.","authors":"Haydn Hoffman, Salvador Miralbés, Bharath Naravetla, Alejandro Spiotta, Christian Loehr, Mario Martínez-Galdámez, Ryan McTaggart, Luc Defreyne, Pedro Vega, Osama O Zaidat, Lori Lyn Price, David S Liebeskind, Markus Möhlenbruch, Rishi Gupta, Nitin Goyal","doi":"10.1177/15910199251344031","DOIUrl":"https://doi.org/10.1177/15910199251344031","url":null,"abstract":"<p><p>BackgroundMultiple studies have evaluated whether general anesthesia (GA) improves outcomes after mechanical thrombectomy (MT) with mixed results. Many of these did not include procedural outcomes such as time to recanalization, degree of recanalization, and first pass effect (FPE).MethodsThe ASSIST registry, a prospective, global, multicenter registry of patients undergoing anterior circulation MT was used. Adults with internal carotid artery or M1/2 occlusions were included. The variable of interest was type of anesthesia used during MT, which was dichotomized to GA or non-GA. The outcomes of interest were time from arterial puncture to recanalization in patients who achieved extended thrombolysis in cerebral infarction (eTICI) ≥ 2b50 recanalization, final recanalization with eTICI ≥ 2c, first pass recanalization with eTICI ≥2 c (FPE), intraprocedural complications, 90-day favorable outcome (modified Rankin scale 0-2), symptomatic intracranial hemorrhage (sICH), any ICH, and early neurological deterioration (defined as an increase in NIHSS ≥ 4 points from baseline up to 48 hours after MT). Multivariable regression models were generated for each outcome.ResultsThere were 1477 patients who underwent MT (38.9% under GA). In the multivariable analysis GA was not significantly associated with time from arterial puncture to recanalization (p = 0.08) but was significantly associated with greater odds of final recanalization with eTICI ≥ 2c (odds ration (OR) 1.62, 95% confidence interval (CI) 1.11-2.36). There was no difference in the odds of intraprocedural complications for the GA group (OR 0.73, 95% CI 0.28-1.92). GA was also not associated with 90-day favorable outcome, sICH, any ICH, END, or FPE.ConclusionGA for MT is associated with greater odds of eTICI ≥ 2c final recanalization.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251344031"},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of using a large bore guide catheter through a short 8-Fr sheath for transradial neurointerventional procedures.","authors":"Preethi Reddi, Daryl Goldman, Halima Tabani, Ayesha Hashmi, Amol Mehta, Christopher P Kellner, Reade De Leacy, J Mocco, Shahram Majidi","doi":"10.1177/15910199251345034","DOIUrl":"10.1177/15910199251345034","url":null,"abstract":"<p><p>IntroductionDespite broader acceptance of transradial approach (TRA) for neurointerventional procedures, there is a paucity of data describing the technique and safety of using a short 8-Fr sheath with large bore 8-French guide catheters in the radial artery. The purpose of this study is to describe the technique and evaluate the safety and feasibility of a short 8-Fr sheath in the radial artery for neurointerventional procedures.MethodsConsecutive patients who had neurointerventional procedures with TRA using a short 8-Fr sheath between January 2019 and March 2024 were identified retrospectively utilizing our prospectively maintained institutional database. Procedures were evaluated for technical success, radial artery avulsion or extravasation, and the rate of radial artery patency among patients who had a follow-up procedure.ResultsTRA with a short 8-Fr sheath was attempted in 94 consecutive patients (52.1% women; median age 68 years) for a total of 111 procedures. TRA procedures were successfully completed in 82.0% (<i>n</i> = 100) of the cases. 20 procedures (18.0%) required crossover to TFA. In 28 patients who underwent radial artery ultrasound at follow-up angiography (median follow-up time 8.1 months), 23 patients (82.1%) had a patent radial artery, while 17.9% (<i>n</i> = 5) had partial thrombosis of the radial artery, which was recanalized by the access wire.ConclusionUsing a short 8-Fr sheath during TRA for neurointerventional procedures with large bore 8-Fr guide catheters is safe and feasible, with a high procedural success and favorable safety profile.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251345034"},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic migraine and bilateral occlusion of the middle meningeal artery.","authors":"José Ricardo Vanzin, Luciano Bambini Manzato","doi":"10.1177/15910199251337520","DOIUrl":"10.1177/15910199251337520","url":null,"abstract":"<p><p>BackgroundMigraine is the most common neurological problem in primary care affecting 18% of women and 6% of men, while chronic migraine affects 2% of the population and refractory migraine is estimated to affect between 5% and 30% of migraine sufferers. The dura is a well-vascularized structure, which is densely innervated by pain fibers. Intra-arterial administration of lidocaine in the middle meningeal artery (MMA) has been used for refractory migraine, promoting pain relief. Patients with chronic headaches who underwent embolization of the MMA for the prevention of chronic subdural hematoma recurrence experienced complete resolution of pain.MethodsBased on this data, we treated 10 patients consecutively with chronic and refractory migraine with a high degree of disability assessed by headache impact test (HIT-6) who experimented with pain relief with lidocaine injection and subsequently underwent definitive bilateral occlusion of the MMA with biological glue.ResultsMean age was 48.2 ± 14.4, with 90% being female, all patients confirmed primary headache in the lidocaine suppression test (LST) and after bilateral occlusion was observed worsening of pain between 0 h and 6 h (-0.9 (95% CI -2.2-0.6, <i>P</i> = 0.193) with complete improvement at discharge within 24 h. In the 30-day follow-up, we observed a significant improvement in HIT-6, 30.5 (95% CI 25.5-35.5, <i>P</i> < 0.001) that lasted up to 6 months. No neurological or technical complications were observed.ConclusionsPatients with chronic or refractory migraine, rigorously selected through the LST, may benefit from bilateral occlusion of the MMA for a period of up to 6 months, without additional risks. Despite the positive results, we must emphasize the preliminary nature of these findings, especially given the small sample size. A multicenter, randomized study is needed to prove the efficacy and safety of this new treatment and it may be an alternative for a specific subset of patients.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251337520"},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial experience with ultra-large-bore catheter aspiration for very large vessel occlusions.","authors":"Andie Conching, Thomas Mandel Clausen, Ryan Nakamura, Shao-Pow Lin, Matthew T Bender, Yi Jonathan Zhang, Samuel Tsappidi, Ferdinand K Hui","doi":"10.1177/15910199251343666","DOIUrl":"10.1177/15910199251343666","url":null,"abstract":"<p><p>The vessels involved in very large vessel occlusions (VLVOs) have a lumen substantially larger than the diameter of intracranial thrombectomy catheters. As such, direct aspiration in VLVOs may only remove channels within the thrombus mass. Ultra-large bore catheters, 12 F or similar, have cross-sectional areas more comparable to those of the internal carotid artery and the superior sagittal sinus. The off-label use of these catheters may therefore maximize the potential for successful recanalization in VLVO. We report four cases of VLVO aspiration thrombectomy using a 12-F catheter. To our knowledge, this is the first reported use of this catheter in carotid artery occlusions. In this study, material use logs at two centers were reviewed to identify cases where aspiration thrombectomy for VLVO was performed using the Lightning 12 (Penumbra, Alameda, CA, USA). Patient demographics, imaging findings, and case details were collected and compared. Four patients were identified: two with superior sagittal sinus thrombosis and two with internal carotid artery occlusion. Aspiration with the Lightning 12 ultimately resulted in successful blood flow restoration for three patients. In the fourth case, the utility of the Lightning 12 was limited by a variant torcular. The only complication was the unsuccessful dual Perclose closure in case three. The off-label use of ultra-large-bore aspiration catheters may be an effective tool in VLVO thrombectomy. Further experience is needed.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251343666"},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}