Neurosurgery practice · 2025
Steam Shaping of Angled-Tip Aspiration Catheter to Improve Deliverability in Treating Acute Ischemic Stroke.
СтатьяНазвание и аннотация: Перевод в очереди
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Badger Clint, Trang Annie, Singha Souvik, Arnold Matthew, Majmundar Shyam, Miller Timothy, Gandhi Dheeraj, Cherian Jacob
Аннотация
BACKGROUND AND OBJECTIVES: Innovations in the treatment of large vessel occlusion strokes include maximizing the speed and success in clot retrieval, but there is limited exploration of steam shaping to angled-tip aspiration catheters. The objective of our study was to assess the outcomes and efficacy of steam-shaped angled-tip aspiration catheters in conjunction with a nonwire advancement technique.
METHODS: Our case series included patients with anterior circulation large vessel occlusion using a nonwire advancement technique with a steam-shaped angled-tip aspiration catheter (Zoom 71TM Imperative Care, Inc.). Outcomes were aspiration passes, time to first pass and recanalization, degree of final reperfusion (thrombolysis in cerebral infarction), and adverse outcomes.
RESULTS: Of the 10 cases analyzed, 60% were men, with a median age of 70 (IQR 62.3-75.5) and a median National Institutes of Health Stroke Scale score of 22.5 (IQR 19.3-25.0). Overall, 70% had singular occlusions, whereas tandem occlusions included 1 internal carotid artery (ICA)-M1 and 2 ICA-M2 cases. Most (60%) had a cavernous carotid siphon angle type II. First pass took 11.5 minutes (IQR 10.0-15.0), and recanalization took 20.0 minutes (IQR 15.8-25.8) with an average of 2.2 passes. For singular occlusions, 57.1% of cases required 2 or fewer passes. The tandem ICA-M1 occlusion needed only one pass at each location, whereas both ICA-M2 occlusions required 1 ICA pass with ZoomTM 71 with a pass at M2 with ZoomTM 45. Overall, 80% of cases achieved a final thrombolysis in cerebral infarction score of 2C or greater. There were no intraoperative complications, although 4 cases presented with postoperative complications and 1 death unrelated to the procedure. In all cases, the aspiration catheter was able to be delivered without the use of another device.
CONCLUSION: Steam shaping of angled-tip catheters seems to perform superiorly when utilizing a nonwire advancement technique without compromising patient safety.
METHODS: Our case series included patients with anterior circulation large vessel occlusion using a nonwire advancement technique with a steam-shaped angled-tip aspiration catheter (Zoom 71TM Imperative Care, Inc.). Outcomes were aspiration passes, time to first pass and recanalization, degree of final reperfusion (thrombolysis in cerebral infarction), and adverse outcomes.
RESULTS: Of the 10 cases analyzed, 60% were men, with a median age of 70 (IQR 62.3-75.5) and a median National Institutes of Health Stroke Scale score of 22.5 (IQR 19.3-25.0). Overall, 70% had singular occlusions, whereas tandem occlusions included 1 internal carotid artery (ICA)-M1 and 2 ICA-M2 cases. Most (60%) had a cavernous carotid siphon angle type II. First pass took 11.5 minutes (IQR 10.0-15.0), and recanalization took 20.0 minutes (IQR 15.8-25.8) with an average of 2.2 passes. For singular occlusions, 57.1% of cases required 2 or fewer passes. The tandem ICA-M1 occlusion needed only one pass at each location, whereas both ICA-M2 occlusions required 1 ICA pass with ZoomTM 71 with a pass at M2 with ZoomTM 45. Overall, 80% of cases achieved a final thrombolysis in cerebral infarction score of 2C or greater. There were no intraoperative complications, although 4 cases presented with postoperative complications and 1 death unrelated to the procedure. In all cases, the aspiration catheter was able to be delivered without the use of another device.
CONCLUSION: Steam shaping of angled-tip catheters seems to perform superiorly when utilizing a nonwire advancement technique without compromising patient safety.