Improving endovascular access to the target vessel for thrombus aspiration -Use of the wedge device to overcome anatomic hurdles.

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences
Roisin M O'CearbhaillJ Thornton

Abstract

Aspiration is a successful technique used in thrombectomy for acute stroke. It is contingent upon the appropriate position of the aspiration catheter, so that it is in contact with the thrombus. However, navigating the craniocervical vasculature is challenging is some patients. The wedge microcatheter (MicroVention®) is designed to reduce the gap between the microcatheter and the SofiaPlus 6F catheter for ease of advancement. The purpose of this study is to describe our initial experience with the wedge microcatheter. A retrospective review of 38 consecutive patients in whom the wedge microcatheter was used during thrombectomy was performed to determine whether the wedge microcatheter was successful in delivering the Sofia catheter to the desired location. We have found this device to be successful in delivering the aspiration catheter to the correct position in 97% (N = 37) of cases. It was used predominantly to pass the origin of branching vessels and also to navigate the tortuous cavernous and petrous segments of the ICA. The wedge microcatheter is a successful tool in delivering the aspiration catheter to the desired vessel for revascularisation.

References

Dec 18, 2014·The New England Journal of Medicine·Olvert A BerkhemerUNKNOWN MR CLEAN Investigators
Feb 12, 2015·The New England Journal of Medicine·Mayank GoyalUNKNOWN ESCAPE Trial Investigators
Nov 14, 2017·The New England Journal of Medicine·Raul G NogueiraUNKNOWN DAWN Trial Investigators
Jan 25, 2018·The New England Journal of Medicine·Gregory W AlbersUNKNOWN DEFUSE 3 Investigators
Feb 21, 2018·Stroke; a Journal of Cerebral Circulation·Osama O ZaidatRaul G Nogueira
Jul 25, 2018·Journal of Neurointerventional Surgery·Aquilla S TurkImran Chaudry
Feb 18, 2019·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Christopher T PrimianiMaxim Mokin
Jul 20, 2019·AJNR. American Journal of Neuroradiology·D O'NeillJ Thornton
Sep 1, 2019·Journal of Neurointerventional Surgery·Célina DucrouxUNKNOWN ASTER Trial investigators

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Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.

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