抽吸导管的结构分析与手术结果:SVIN 登记分析

Jay Dolia, Mahmoud H. Mohammaden, Mohamed A. Tarek, Mateus Damiani, J. Grossberg, A. Pabaney, Michael V. Frankel, D. Jillella, A. Hassan, Wondwossen G. Tekle, Alexandros Georgiadis, Hamzah M Saei, S. Ortega‐Gutierrez, J. Vivanco-Suarez, M. Galecio-Castillo, A. Rodriguez-Calienes, Shahram Majidi, Johanna T. Fifi, S. Matsoukas, James E. Siegler, Mary Penckofer, Ankit Rana, Sunil Sheth, Sergio A. Salazar Marioni, Thanh N. Nguyen, M. Abdalkader, Italo Linfante, G. Dabus, Brijesh P. Mehta, Joy Sessa, M. Jumaa, Rebecca Sugg, Guillermo Linares, A. Al-Bayati, David S. Libeskind, Raul G. Nogueira, Diogo C. Haussen
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引用次数: 0

摘要

机械血栓切除术的快速发展和生产工艺的迅猛发展使大口径导管技术发生了重大演变。本研究的目的是评估大口径抽吸导管的不同结构组件对手术性能的影响。 该研究对 2012 年至 2021 年期间在大脑中动脉 M1 或颅内颈内动脉闭塞中首次使用独立接触式抽吸术治疗的前瞻性机械血栓切除术联盟(SVIN [血管介入神经病学学会] 注册)进行了回顾性分析。根据导管的结构材料、尖端技术、导管尺寸和导管内衬对导管进行了分层。我们分析了与首通效果(首通 eTICI 2c-3 再灌注)和血块介入速度相关的因素。 我们确定了 983 例使用近端闭塞和抽吸作为首通技术的患者。87])、非全身麻醉(OR,0.55 [95% CI,0.39-0.767])以及0.070英寸(OR,2.04 95% CI,1.01-3.78])和0.088英寸(OR,3.90 [95% CI,1.58-9.61])远端导管内径的调整分析。从动脉接入到接触血凝块的平均时间为 17 分钟,年轻患者的时间更短(OR,0.99 [95% CI,0.98-0.996]),使用远端外亲水涂层长度较短(18-30 厘米)的抽吸导管的多变量回归结果也更短(OR,0.30 [95% CI,0.11-0.82])。 吸液导管远端内径越大,首过效应率越高。研究发现,抽吸导管的结构部件会影响从动脉接入到血凝块接触的时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Structural Analysis of Aspiration Catheters and Procedural Outcomes: An Analysis of the SVIN Registry
Rapid expansion of mechanical thrombectomy and swift manufacturing development has translated into significant evolution of large‐bore catheter technology. The objective of this study was to evaluate the association among diverse structural components of large‐bore aspiration catheters on procedural performance. Retrospective analysis of a prospectively maintained mechanical thrombectomy consortium (SVIN [Society of Vascular Interventional Neurology] Registry) treated with stand‐alone contact aspiration for the first pass in the middle cerebral artery M1 or intracranial internal carotid artery occlusions from 2012 to 2021. Catheters were stratified on the basis of construction materials, tip technology, catheter sizing, and catheter lining. Factors associated with first‐pass effect (first‐pass eTICI 2c–3 reperfusion) as well as speed of clot engagement were analyzed. We identified 983 patients with proximal occlusion and aspiration as the first‐pass technique. First‐pass effect was observed in 34% and associated with age (odds ratio [OR], 1.02 [95% CI, 1.01–1.03]), cardioembolic stroke pathogenesis (OR, 1.69 [95% CI, 1.77–2.41]), middle cerebral artery M1 (OR, 2.74 [95% CI, 1.09–1.87]), nongeneral anesthesia (OR, 0.55 [95% CI, 0.39–0.767]), as well as with 0.070‐inch (OR, 2.04 95% CI, 1.01–3.78]), and 0.088‐inch (OR, 3.90 [95% CI, 1.58–9.61]) distal catheter inner diameter in the adjusted analysis. Mean time from arterial access to clot contact was 17 minutes, with faster times observed in younger patients (OR, 0.99 [95% CI, 0.98–0.996]) as well as with the use of aspiration catheters with shorter length of distal outer hydrophilic coating (18–30 cm) on multivariable regression (OR, 0.30 [95% CI, 0.11–0.82]). Larger aspiration catheter distal inner diameter was associated with higher rates of first‐pass effect. Aspiration catheter construction components were found to influence times from arterial access to clot contact.
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