Journal of Cerebrovascular and Endovascular Neurosurgery

  • 제26권3호
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  • Pages.311-317
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  • 2024
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  • 2234-8565(pISSN)
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  • 2287-3139(eISSN)
대한뇌혈관외과학회 (Korean Society of Cerebravascular Surgeons)
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Suction thrombectomy of distal medium vessel occlusion using microcatheter during mechanical thrombectomy for acute ischemic stroke: A case series

  • Eun-Oh Jeong (Department of Neurosurgery, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Hyon-Jo Kwon (Department of Neurosurgery, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Heewon Jeong (Department of Neurosurgery, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Han-Joo Lee (Department of Neurosurgery, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Kyung Hwan Kim (Department of Neurosurgery, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Hyeon-Song Koh (Department of Neurosurgery, Chungnam National University Hospital, Chungnam National University School of Medicine)
  • 투고 : 2023.11.06
  • 심사 : 2023.12.21
  • 발행 : 2024.09.30
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초록

While mechanical thrombectomy is known to be effective for distal medium vessel occlusion (DMVO) as well as large vessel occlusion, tortuous DMVO are predisposed to vessel injury during stent retriever thrombectomy. Furthermore, getting access to the thrombus may be difficult during suction thrombectomy using a dedicated suction catheter. Most studies describe DMVO treatment using stent retrievers and dedicated suction catheters, but there are limited studies reporting DMVO treated with suction thrombectomy using a microcatheter. Herein, we describe three cases of DMVO treated with suction thrombectomy that was performed using a microcatheter and subsequently showed good results. Therefore, suction thrombectomy using a microcatheter is a viable alternative treatment for tortuous DMVO.

키워드

과제정보

This work was supported by research fund of Chungnam National University.

참고문헌

  1. Berkhemer OA, Fransen PS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015 Jan;372(1):11-20. 
  2. Campbell BC, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Yassi N, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015 Mar;372(11):1009-18. 
  3. Crockett MT, Phillips TJ, Chiu AHY. Dual suction Head-way27 microcatheter thrombectomy for the treatment of distal intracranial arterial occlusion strokes: Initial experience with the micro-ADAPT technique. J Neurointerv Surg. 2019;11(7):714-8. 
  4. Drakopoulou M, Giannopoulou A, Zampakis P, Messinis L, Theofanopoulos A, Constantoyannis C, et al. Suction thrombectomy using a microcatheter as a salvage method for acute distal occlusion during cerebral aneurysm embolization: A case report. Brain Circ. 2022 Jun;8(2):112-6. 
  5. Froehler MT. Comparison of vacuum pressures and forces generated by different catheters and pumps for aspiration thrombectomy in acute ischemic stroke. Interv Neurol. 2017 Oct;6(3-4):199-206. 
  6. Gory B, Lapergue B, Blanc R, Labreuche J, Ben Machaa M, Duhamel A, et al. Contact aspiration versus stent retriever in patients with acute ischemic stroke with M2 occlusion in the ASTER randomized trial (contact aspiration versus stent retriever for successful revascularization). Stroke. 2018 Feb;49(2):461-4. 
  7. Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornton J, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med. 2015 Mar;372(11):1019-30. 
  8. Gross BA, Jadhav AP, Jovin TG, Jankowitz BT. Dump the pump: Manual aspiration thrombectomy (MAT) with a syringe is technically effective, expeditious, and cost-efficient. J Neurointerv Surg. 2018 Apr;10(4):354-7. 
  9. Gunning GM, McArdle K, Mirza M, Duffy S, Gilvarry M, Bouwer PA. Clot friction variation with fibrin content; implications for resistance to thrombectomy. J Neurointerv Surg. 2018 Jan;10(1):34-8. 
  10. Haussen DC, Eby B, Al-Bayati AR, Grossberg JA, Rodrigues GM, Frankel MR, et al. A comparative analysis of 3MAX aspiration versus 3 mm Trevo Retriever for distal occlusion thrombectomy in acute stroke. J Neurointerv Surg. 2020 Mar;12(3):279-82. 
  11. Haussen DC, Lima A, Nogueira RG. The Trevo XP 3×20 mm retriever ('Baby Trevo') for the treatment of distal intracranial occlusions. J Neurointerv Surg. 2016 Mar;8(3):295-9. 
  12. Jovin TG, Chamorro A, Cobo E, de Miquel MA, Molina CA, Rovira A, et al. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med. 2015 Jun;372(24):2296-306. 
  13. Kwon HJ, Shin JW, Park BS, Lim JW, Jeong HS, Song HJ, et al. Use of microcatheters for suction thrombectomy of acute distal occlusions. Neuroradiology. 2018 Dec;60(12):1357-60. 
  14. Mokin M, Fargen KM, Primiani CT, Ren Z, Dumont TM, Brasiliense LB, et al. Vessel perforation during stent retriever thrombectomy for acute ischemic stroke: Technical details and clinical outcomes. J Neurointerv Surg. 2017 Oct;9(10):922-8. 
  15. Mokin M, Primiani CT, Ren Z, Kan P, Duckworth E, Turner RD 4th, et al. Endovascular treatment of middle cerebral artery M2 occlusion strokes: Clinical and procedural predictors of outcomes. Neurosurgery. 2017 Nov;81(5):795-802. 
  16. Navia P, Larrea JA, Pardo E, Arce A, Martinez-Zabaleta M, Diez-Gonzalez N, et al. Initial experience using the 3MAX cerebral reperfusion catheter in the endovascular treatment of acute ischemic stroke of distal arteries. J Neurointerv Surg. 2016 Aug;8(8):787-90. 
  17. Qiu K, Zhao LB, Xu XQ, Wang Y, Liu J, Liu S, et al. Acute embolic stroke with large-vessel occlusion: Does contact aspiration thrombectomy show superiority? Clin Radiol. 2022 Aug;77(8):577-83. 
  18. Saber H, Narayanan S, Palla M, Saver JL, Nogueira RG, Yoo AJ, et al. Mechanical thrombectomy for acute ischemic stroke with occlusion of the M2 segment of the middle cerebral artery: A meta-analysis. J Neurointerv Surg. 2018 Jul;10(7):620-4. 
  19. Sarraj A, Sangha N, Hussain MS, Wisco D, Vora N, Elijovich L, et al. Endovascular therapy for acute ischemic stroke with occlusion of the middle cerebral artery M2 segment. JAMA Neurol. 2016 Nov;73(11):1291-6. 
  20. Saver JL, Goyal M, Bonafe A, Diener HC, Levy EI, Pereira VM, et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med. 2015 Jun;372(24):2285-95. 
  21. Sepp D, Hernandez Petzsche MR, Zarth T, Wunderlich S, Ikenberg B, Maegerlein C, et al. Mechanical thrombectomy of distal cerebral vessel occlusions of the anterior circulation. Sci Rep. 2023 Apr;13(1):5730. 
  22. Vargas J, Spiotta AM, Fargen K, Turner RD, Chaudry I, Turk A. Experience with a direct aspiration first pass technique (ADAPT) for thrombectomy in distal cerebral artery occlusions causing acute ischemic stroke. World Neurosurg. 2017 Mar;99:31-6.