Background and purpose:Stent retriever thrombectomy is the standard therapeutic approach for ischemic stroke with acute large-vessel occlusion.This study evaluated the safety and efficacy of a new thrombectomy device(...Background and purpose:Stent retriever thrombectomy is the standard therapeutic approach for ischemic stroke with acute large-vessel occlusion.This study evaluated the safety and efficacy of a new thrombectomy device(Skyflow)in the treatment of acute ischemic stroke.Methods:After an arterial occlusion model was established,stent-retriever thrombectomy was performed.Digital subtraction angiography(DSA)and autopsy were carried out immediately after thrombectomy in six animals in the acute experimental group.Simulated stent-retriever thrombectomy was performed for three animals in the subacute experimental group,and follow-up angiography and vascular pathological examination were assessed 90 days after the operation.In the clinical trial,192 patients with intracranial anterior circulation large vessel occlusion,within 8 h of symptom onset,were included to undergo thrombectomy with either Skyflow or Solitaire FR stent retriever.Efficacy and safety endpoints were recorded(including successful reperfusion,favorable clinical outcomes,time from puncture to reperfusion,instrument operation success rates and National Institutes of Health Stroke Scale(NIHSS)scores at 7 days for efficacy endpoints,and symptomatic intracranial hemorrhage(sICH),subarachnoid hemorrhage(SAH)and all-cause mortality rates for safety endpoints).Results:All blood vessels achieved successful recanalization in the animal models.In the clinical trial,successful recanalization was attained in 88.4%of patients of the Skyflow group,which was comparable to that of the Solitaire FR group(82.5%)in the full analysis set of the clinical trial.There were no severe complications on DSA,an animal autopsy,or vessel pathological examination in animal experiments.Additionally,no statistically significant difference was observed between the Skyflow and Solitaire FR groups in the clinical trial regarding the safety endpoints.Conclusion:This study showed that the new Skyflow stent retriever is safe and effective for the treatment of acute large vessel occlusion,as demonstrated in our animal study and human trial.展开更多
Objective and Importance: The authors report a case of a symptomatic giant serpentine MCA aneurysm treated with double STA-MCA bypass with thrombectomy and excision of aneurysm. This is the first reported case of a do...Objective and Importance: The authors report a case of a symptomatic giant serpentine MCA aneurysm treated with double STA-MCA bypass with thrombectomy and excision of aneurysm. This is the first reported case of a double bypass with concomitant thrombectomy and excision of aneurysmal segment. Clinical Presentation/Methods: We report the case of a 27-year-old Hispanic male with severe acute decline in mental status with a giant serpentine MCA aneurysm with significant mass effect and midline shift trapping the lateral ventricular system. Intervention/Results: Patient presented initially to an outside hospital for altered mental status and confusion. Patient was diagnosed with a giant serpiginous aneurysm and hydrocephalus. A left ventriculoperitoneal shunt was placed at the outside hospital and patient was transferred to University of New Mexico. At this time, his mental status declined rather abruptly. He was treated with a double STA-MCA bypass procedure with aneurysm resection.展开更多
基金supported by the Co-construction of Provincial and Ministry Youth Project(SBGJ202003004)Key Research and Development Program of Henan Province(Scientific and Technological Project of Henan Province)(202102310037)
文摘Background and purpose:Stent retriever thrombectomy is the standard therapeutic approach for ischemic stroke with acute large-vessel occlusion.This study evaluated the safety and efficacy of a new thrombectomy device(Skyflow)in the treatment of acute ischemic stroke.Methods:After an arterial occlusion model was established,stent-retriever thrombectomy was performed.Digital subtraction angiography(DSA)and autopsy were carried out immediately after thrombectomy in six animals in the acute experimental group.Simulated stent-retriever thrombectomy was performed for three animals in the subacute experimental group,and follow-up angiography and vascular pathological examination were assessed 90 days after the operation.In the clinical trial,192 patients with intracranial anterior circulation large vessel occlusion,within 8 h of symptom onset,were included to undergo thrombectomy with either Skyflow or Solitaire FR stent retriever.Efficacy and safety endpoints were recorded(including successful reperfusion,favorable clinical outcomes,time from puncture to reperfusion,instrument operation success rates and National Institutes of Health Stroke Scale(NIHSS)scores at 7 days for efficacy endpoints,and symptomatic intracranial hemorrhage(sICH),subarachnoid hemorrhage(SAH)and all-cause mortality rates for safety endpoints).Results:All blood vessels achieved successful recanalization in the animal models.In the clinical trial,successful recanalization was attained in 88.4%of patients of the Skyflow group,which was comparable to that of the Solitaire FR group(82.5%)in the full analysis set of the clinical trial.There were no severe complications on DSA,an animal autopsy,or vessel pathological examination in animal experiments.Additionally,no statistically significant difference was observed between the Skyflow and Solitaire FR groups in the clinical trial regarding the safety endpoints.Conclusion:This study showed that the new Skyflow stent retriever is safe and effective for the treatment of acute large vessel occlusion,as demonstrated in our animal study and human trial.
文摘Objective and Importance: The authors report a case of a symptomatic giant serpentine MCA aneurysm treated with double STA-MCA bypass with thrombectomy and excision of aneurysm. This is the first reported case of a double bypass with concomitant thrombectomy and excision of aneurysmal segment. Clinical Presentation/Methods: We report the case of a 27-year-old Hispanic male with severe acute decline in mental status with a giant serpentine MCA aneurysm with significant mass effect and midline shift trapping the lateral ventricular system. Intervention/Results: Patient presented initially to an outside hospital for altered mental status and confusion. Patient was diagnosed with a giant serpiginous aneurysm and hydrocephalus. A left ventriculoperitoneal shunt was placed at the outside hospital and patient was transferred to University of New Mexico. At this time, his mental status declined rather abruptly. He was treated with a double STA-MCA bypass procedure with aneurysm resection.
