新型Envoy DA导引导管在神经介入治疗中的应用经验

The experience of newly designed Envoy DA distal access guiding catheter in neuro-interventional therapy

目的:总结新型远端通路导引导管(Envoy DA)在神经介入治疗中的应用技术及适应证。方法:回顾我中心2年内神经介入治疗中使用新型Envoy DA的50例患者的临床资料,分析Envoy DA导管是否顺利输送到目标位置,是否能够为后续血管内治疗提供满意支撑,评估手术即刻临床及影像结果及有无围手术期导引导管相关并发症,总结Envoy DA在神经介入治疗中应用的适应证。结果:50例患者共计使用50根Envoy DA,其中46例(92.0%)顺利到达治疗所需支撑位置;2例(4.0%)未达目标位置,支撑效果不理想,经反复操作技术调整后完成手术;2例(4.0%)支撑失败后撤出,更换长鞘配合中间导管支撑完成治疗。1例(2.0%)患者术中发生导引导管相关夹层伴导管口血栓形成,1例(2.0%)患者发生导引导管相关颈动脉海绵窦瘘,围手术期导管相关并发症率4.0%。所有目标病变最终成功完成目标病变手术,手术技术成功率100%。结论:使用新型Envoy DA进行神经介入治疗需合理选择病例、正确操作才可发挥其在适度径路迂曲病变提供足够支撑且操作简捷的优势。

Objective:To discuss the application characteristics,techniques,and indications of the newly designed Envoy DA distal access guiding catheter in neuro-interventional therapy.Methods:We retrospectively analyzed the clinical data of 50 patients who underwent endovascular treatment with Envoy DA distal access catheter within 2 years in our center.We analyzed whether the Envoy DA guiding catheter is successfully delivered to the target position,and provide sufficient support with satisfaction.The immediate effect of the operation and whether there were catheter-related complications during the procedure were evaluated.Then we summarized the indications of using Envoy DA during neuro-interventional therapy.Results:A total of 50 patients used 50 Envoy DA distal access guide catheters,and 46(92.0%)successfully reach the desired position.Two catheters(2.0%)did not reach the target position due to insufficient support,2 catheters were withdrawn after failure and replaced by long sheath accompanied by intermediate catheter to complete the operation.One patient(2.0%)had a guiding catheter-related internal carotid artery petrous segment dissection accompanied by catheter opening thrombosis during the operation,and one patient(2.0%)had a guiding catheter-related carotid cavernous fistula.Perioperative catheter-related complication rate is 4.0%.All the target lesions were successfully treated and the surgical technique success rate was 100%.Conclusions:The use of the newly designed Envoy DA guiding catheter in the treatment of cerebrovascular disease requires a reasonable selection of cases and manipulation to give full play to the advantages of simple operation and sufficient support.