Background

Large-bore aspiration catheters enabling greater flow rates and suction force for mechanical thrombectomy might improve outcomes in patients with stroke secondary to large-vessel occlusion. Complete or near-complete reperfusion after a single thrombectomy pass (first-pass effect) is associated with improved clinical outcomes. We assessed the efficacy and safety of novel MIVI Q™ aspiration catheters in combination with stent-retriever devices.

Methods

We retrospectively analyzed demographics, procedure characteristics, and clinical data from consecutive patients with acute anterior large-vessel occlusion treated with a combined approach using MIVI Q™ aspiration catheters and stent retrievers. Reperfusion was defined according to the modified thrombolysis in cerebral infarction (mTICI) score. Clinical outcomes were measured by the National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores.

Results

We included 52 patients (median age, 75 y IQR: 64–83); 31 (59.6%) women; 14 (26.9%) with terminal internal carotid artery occlusions, 26 (50%) middle cerebral artery (MCA) segment M1 occlusions, and 12 (23.1%) MCA segment M2 occlusions; median NIHSS score at admission was 19 (IQR: 13–22). After the first pass, 25 (48%) patients had mTICI ≥ 2c. At the end of the procedure, 47 (90.4%) had mTICI ≥ 2b and 35 (67.3%) had mTICI ≥ 2c. No serious device-related adverse events were observed. Symptomatic intracranial hemorrhage developed in 1 patient. Mean NIHSS score was 13 at 24 h and 5 at discharge. At 90 days, 24 (46.2%) patients were functionally independent (mRS 0–2).

Conclusion

This preliminary study found good efficacy and safety for MIVI Q™ aspiration catheters used in combination with stent-retriever devices.

中文翻译：

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使用新型短柔性抽吸导管和支架取栓器联合进行中风血栓切除术

背景

大口径抽吸导管能够提高机械血栓切除术的流速和抽吸力，可能会改善继发于大血管闭塞的中风患者的预后。单次取栓后的完全或接近完全的再灌注（首过效应）与改善的临床结果相关。我们评估了新型 MIVI Q™ 抽吸导管与支架回收装置相结合的有效性和安全性。

方法

我们回顾性分析了使用 MIVI Q™ 抽吸导管和支架取栓器联合治疗急性前部大血管闭塞的连续患者的人口统计学、手术特征和临床数据。根据改良的脑梗死溶栓（mTICI）评分定义再灌注。临床结果通过美国国立卫生研究院卒中量表 (NIHSS) 和改良 Rankin 量表 (mRS) 评分来衡量。

结果

我们纳入了 52 名患者（中位年龄，75 岁 IQR：64-83）；31 名（59.6%）女性；14 例（26.9%）颈内动脉末端闭塞，26 例（50%）大脑中动脉（MCA）M1 段闭塞，12 例（23.1%）MCA 段 M2 闭塞；入院时 NIHSS 得分中位数为 19（IQR：13-22）。第一次通过后，25 名 (48%) 患者的 mTICI ≥ 2c。手术结束时，47 人 (90.4%) 的 mTICI ≥ 2b，35 人 (67.3%) 的 mTICI ≥ 2c。未观察到严重的与设备相关的不良事件。1 例患者出现症状性颅内出血。平均 NIHSS 评分在 24 小时为 13 分，出院时为 5 分。在 90 天时，24 名 (46.2%) 患者功能独立 (mRS 0-2)。

结论

这项初步研究发现 MIVI Q™ 抽吸导管与支架回收装置结合使用具有良好的疗效和安全性。