Daniel A Tonetti, Manisha Koneru, Meghna Bhattacharyya, Joey D English, Fabio Settecase, Warren T Kim, Jane Khalife, Pratit Patel, Ajith Thomas, Tudor Jovin, Ricardo Hanel, Victor H C Benalia, Gustavo M Cortez, Amin Aghaebrahim, Eric Sauvageau, Mohamad Abdalkader, Thanh N Nguyen, Piers Klein, Adam A Dmytriw, Hamza Shaikh
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This multicenter experience aims to describe AC delivery success in single-pass thrombectomy using T7 with and without a leading microwire.</p><p><strong>Methods: </strong>A retrospective review was conducted of consecutive patients who underwent single-pass thrombectomy with T7 at six institutions between 2020 and 2022. We examined the percentage of successful AC delivery, puncture-to-revascularization time, and procedural complication rate.</p><p><strong>Results: </strong>A leading microwire with T7 was used in 19/89 (21%) of patients, and it was not used with T7 in 70/89 (79%) of patients. Successful AC delivery was similar with and without microwires (97% vs. 90%, p = 0.15). Median puncture-to-revascularization times were similar (17 min microwire vs. 16 min no-microwire, p = 0.12). No complications were associated with microwire use; one (1.4%) patient had a T7-related vasospasm resolved with verapamil during thrombectomy without a leading microwire. Differences in complication rates were not statistically significant (p = 0.46).</p><p><strong>Conclusion: </strong>In our real-world clinical experience, leading microwire use was infrequently necessary with the T7 delivery catheter. Successful AC delivery and complication rates were similar with and without microwire use in single-pass T7 thrombectomies. Initial pass with T7 may be performed without use of leading microwire, reserving microwire use for refractory cases or known difficult-to-navigate vasculature.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Tenzing 7 delivery catheter with or without a leading microwire for single pass aspiration thrombectomy: A multicenter experience.\",\"authors\":\"Daniel A Tonetti, Manisha Koneru, Meghna Bhattacharyya, Joey D English, Fabio Settecase, Warren T Kim, Jane Khalife, Pratit Patel, Ajith Thomas, Tudor Jovin, Ricardo Hanel, Victor H C Benalia, Gustavo M Cortez, Amin Aghaebrahim, Eric Sauvageau, Mohamad Abdalkader, Thanh N Nguyen, Piers Klein, Adam A Dmytriw, Hamza Shaikh\",\"doi\":\"10.1177/15910199231216765\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Aspiration mechanical thrombectomy traditionally includes use of an inner microcatheter and leading microwire to navigate an aspiration catheter (AC) to the site of occlusion. Early clinical experience suggests that a leading microwire is often not needed with the Tenzing 7 (T7, Route 92 Medical, San Mateo, CA), a soft tapered tip ledge-reducing delivery catheter. This multicenter experience aims to describe AC delivery success in single-pass thrombectomy using T7 with and without a leading microwire.</p><p><strong>Methods: </strong>A retrospective review was conducted of consecutive patients who underwent single-pass thrombectomy with T7 at six institutions between 2020 and 2022. We examined the percentage of successful AC delivery, puncture-to-revascularization time, and procedural complication rate.</p><p><strong>Results: </strong>A leading microwire with T7 was used in 19/89 (21%) of patients, and it was not used with T7 in 70/89 (79%) of patients. Successful AC delivery was similar with and without microwires (97% vs. 90%, p = 0.15). Median puncture-to-revascularization times were similar (17 min microwire vs. 16 min no-microwire, p = 0.12). 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引用次数: 0
摘要
导读:传统的机械抽吸取栓包括使用内微导管和前导微丝引导抽吸导管(AC)到达闭塞部位。早期临床经验表明,Tenzing 7 (T7, Route 92 Medical, San Mateo, CA)通常不需要前置微丝,这是一种软锥形尖端减少壁架的输送导管。这个多中心的经验旨在描述在T7有或没有前置微丝的单通道血栓切除术中交流电输送的成功。方法:回顾性分析2020年至2022年6家机构连续接受T7单通取栓的患者。我们检查了AC输注成功率、穿刺至血运重建时间和手术并发症发生率。结果:19/89(21%)的患者使用前置微丝带T7, 70/89(79%)的患者未使用前置微丝带T7。有无微丝的交流电输送成功率相似(97% vs 90%, p = 0.15)。穿刺至血运重建的中位时间相似(微针置入17分钟vs无微针置入16分钟,p = 0.12)。使用微丝无并发症;1例(1.4%)患者在取栓过程中使用维拉帕米解决了t7相关的血管痉挛,没有使用前置微丝。两组并发症发生率差异无统计学意义(p = 0.46)。结论:根据我们的实际临床经验,T7输导导管很少需要使用前置微丝。在T7单道血栓切除术中,使用微丝或不使用微丝时,AC输注成功率和并发症发生率相似。T7的初始通径可以不使用导丝,保留微丝用于难固性病例或已知难以导航的血管系统。
Tenzing 7 delivery catheter with or without a leading microwire for single pass aspiration thrombectomy: A multicenter experience.
Introduction: Aspiration mechanical thrombectomy traditionally includes use of an inner microcatheter and leading microwire to navigate an aspiration catheter (AC) to the site of occlusion. Early clinical experience suggests that a leading microwire is often not needed with the Tenzing 7 (T7, Route 92 Medical, San Mateo, CA), a soft tapered tip ledge-reducing delivery catheter. This multicenter experience aims to describe AC delivery success in single-pass thrombectomy using T7 with and without a leading microwire.
Methods: A retrospective review was conducted of consecutive patients who underwent single-pass thrombectomy with T7 at six institutions between 2020 and 2022. We examined the percentage of successful AC delivery, puncture-to-revascularization time, and procedural complication rate.
Results: A leading microwire with T7 was used in 19/89 (21%) of patients, and it was not used with T7 in 70/89 (79%) of patients. Successful AC delivery was similar with and without microwires (97% vs. 90%, p = 0.15). Median puncture-to-revascularization times were similar (17 min microwire vs. 16 min no-microwire, p = 0.12). No complications were associated with microwire use; one (1.4%) patient had a T7-related vasospasm resolved with verapamil during thrombectomy without a leading microwire. Differences in complication rates were not statistically significant (p = 0.46).
Conclusion: In our real-world clinical experience, leading microwire use was infrequently necessary with the T7 delivery catheter. Successful AC delivery and complication rates were similar with and without microwire use in single-pass T7 thrombectomies. Initial pass with T7 may be performed without use of leading microwire, reserving microwire use for refractory cases or known difficult-to-navigate vasculature.
期刊介绍:
Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...