PDF(Pubmed)
Abstract：
To explore the safety and efficacy of Sofia Plus distal access catheter tip shaping for treatment of acute middle cerebral artery embolism. This single-center retrospective study involved patients eligible for acute embolic middle cerebral artery occlusion from January 2020 to October 2021. They were divided into a shaping and non-shaping group according to whether the Sofia Plus catheter tip was shaped intraoperatively. Baseline data, preoperative Alberta Stroke Program Early Computed Tomography (ASPECT) score, National Institutes of Health Stroke Scale (NIHSS) score, onset-to-admission time, admission-to-puncture time, Sofia Plus-clot time, puncture-to-reperfusion time, surgical approach, and use of a stent for rescue thrombectomy were compared between the 2 groups. Postoperative symptomatic intracerebral hemorrhage and the modified Rankin scale score at the 90-day follow-up were observed. In total, 54 patients were enrolled in this study (shaping group, 26 patients; non-shaping group, 28 patients). Their mean age was 64.8 ± 14.6 years, and the proportion of men was 68.5% (37/54). Successful recanalization was achieved in all patients. There were no differences in the baseline data (age, sex, history, pre-admission ASPECT score, or NIHSS score) between the shaping and non-shaping groups. Patients treated with a shaped Sofia Plus catheter had a shorter Sofia Plus-clot time [median (25th, 75th percentile: 4 (4, 7) vs 10.5 (5.25, 14) min, P = .006] and puncture-to-reperfusion time [16.5 (12, 30.5) vs 26 (16.25, 38.25) min, P = .036]. There were significant differences in the surgical approaches between the 2 groups. The rates of a favorable outcome (57.7% vs 64.3%, P = .62) and postoperative symptomatic intracerebral hemorrhage (7.7% vs 3.6%, P = .60) were not significantly different between the groups. Sofia Plus catheter tip shaping improved catheter trafficability and reduced the operative time. It was safe and effective for treatment of acute middle cerebral artery thrombotic occlusion.
摘要：
探讨SofiaPlus远端入路导管头端整形治疗急性大脑中动脉栓塞的安全性和有效性。这项单中心回顾性研究涉及2020年1月至2021年10月符合急性栓塞性大脑中动脉闭塞的患者。根据SofiaPlus导管尖端是否在术中成形，将其分为成形和非成形组。基线数据,术前Alberta卒中计划早期计算机断层扫描（ASPECT）评分，美国国立卫生研究院卒中量表(NIHSS)评分,发病至入院时间,入院至穿刺时间,Sofia加血块时间,穿刺至再灌注时间，手术方法,比较两组患者使用支架进行抢救取栓的情况。观察术后症状性脑出血和90天随访时改良Rankin量表评分。总的来说,本研究纳入了54例患者(塑形组，26例；非塑形组，28名患者）。他们的平均年龄为64.8±14.6岁，男性比例为68.5%(37/54)。所有患者均成功再通。基线数据没有差异(年龄，性别,历史,入院前ASPECT评分,或NIHSS评分）在整形和非整形组之间。用成形的SofiaPlus导管治疗的患者SofiaPlus凝块时间较短[中位数（第25位，第75百分位数：4（4，7）对10.5（5.25，14）分钟，P=.006]和穿刺至再灌注时间[16.5（12，30.5）vs26（16.25，38.25）分钟，P=.036]。两组间手术入路差异有统计学意义。有利结果的发生率（57.7％vs64.3％，P=.62）和术后症状性脑出血（7.7％vs3.6％，P=0.60）两组之间没有显着差异。SofiaPlus导管尖端成形提高了导管的可通行性并减少了手术时间。该方法治疗急性大脑中动脉血栓性闭塞是安全有效的。
