Tom qab ob peb lub sijhawm ntawm thrombectomy stent retriever, kev nyab xeeb thiab kev ua tau zoo ntawm thrombectomy stents tau txuas ntxiv txhim kho. Txij thaum ntawd los, cov txheej txheem sib tw tau tshwm sim: ncaj qha kev ntshaw. Paub tias yog ADAPT (A Direct Aspiration First Pass Technique), cov txheej txheem tso siab rau lub zog loj sab hauv lumen catheter uas tuaj yeem xa mus rau thrombus, uas tuaj yeem ua rau ncaj qha aspirated. Ib qho kev tshawb fawb thaum ntxov tau tshaj tawm tias ADAPT ib leeg ua rau 78 feem pua ntawm kev rov ua dua tshiab. Lub COMPASS sim randomized ADAPT thiab stent retrieval raws li thawj-kab hom kev kawm rau cov hlab ntsha loj occlusive stroke, qhia tau hais tias ob qho tib si cov tswv yim sib npaug yuav ua tau zoo. Cov neeg mob hauv ADAPT pab pawg thawj zaug recanalization tau ua tiav hauv 57 feem pua, thaum cov neeg mob hauv pawg stent yog 51 feem pua. Tsis tas li ntawd, stent retriever combing nrog aspiration catheter rau mechanical thrombectomy tau siv nyob rau hauv 85 feem pua ntawm cov neeg mob hauv pawg stent.
Yog li ntawd, tus tshiab stent retrieval ntaus ntawv yuav haum rau siv nrog ncaj aspiration. Nws tseem hu ua Solumbra txheej txheem. Cov stents thib peb tau txhim kho cov txiaj ntsig angiographic, raws li qhia hauv kev tshawb fawb randomized ntawm 3D revascularization li. Kev vam meej ntawm cov khoom siv uas twb muaj lawm tau teeb tsa lub siab rau kev txhim kho cov stents tshiab. Kev tsim cov cuab yeej tshiab yuav tsum ua qhov tseem ceeb rau qhov yooj yim thiab lub sijhawm ntawm kev xa mus rau lub hom phiaj ntawm lub nkoj, nrog rau kev txhim kho thawj zaug rov ua dua tus nqi.
Kev sib piv ncaj qha ntawm qhov sib txawv thib ob thiab thib peb tiam stents hauv vitro thiab hauv vivo tsiaj qauv pab qhia meej tias cov qauv ntawm stent tuaj yeem pab txhawb kev kho mob zoo dua thiab muab cov lus qhia rau kev txhim kho ntxiv. Ib txoj kev tshawb fawb piv qee qhov txawv teb chaws siv stents. Cov cuab yeej tau muab piv los ntawm ob lub tshuab thiab ob qhov kev sim ua haujlwm.
Cov kev sim tshuab siv tau yog cov phaj compression thiab rub-up traction tests. Cov kev ntsuam xyuas no qhia tau tias cov khoom siv tag nrho xws li tubular stents tsis tuaj yeem ncaj qha piv rau cov khoom siv tsis tiav xws li cov ntawv zoo li stents. Qhov kev ntxhov siab radial ntawm cov khoom siv kuaj feem ntau tau txo qis thaum lub stent txav ntawm 1.5mm mus rau 3.5mm.
Kev ntsuas kev ua haujlwm ntawm lub cuab yeej suav nrog kev ntsuas rov qab, uas tau sim nws lub nkoj anterior thiab posterior tom qab thaum lub cuab yeej tau muab rov qab rau hauv lub nkoj simulated tortuous. Qee cov cuab yeej tau pom tias muaj kev ua raws li cov hlab ntsha zoo ib yam, lwm yam khoom siv tau pom elongation ntawm kev khoov ntse, thiab lwm yam khoom siv hauv qhov kev sim (3x20 mm) ploj tag nrho. Kev sim thrombectomy tau ua los ntawm kev simulated liab (clumped qe ntshav liab) thiab dawb (fibrin-based) thrombi ntawm ntau qhov sib txawv. Tag nrho cov khoom siv kuaj pom tau hais tias qhov loj dawb thrombus tsis tuaj yeem haum thiab hloov chaw, thaum nruab nrab thiab me me dawb thrombus muaj qhov sib txawv ntawm qhov haum thiab hloov chaw. Cov thrombus liab yog haum kiag li, tab sis fragmentation tau tshwm sim pom tseeb, thiab muaj peev xwm ntawm distal embolism.
Txoj kev txhim kho yav tom ntej ntawm cov khoom siv thrombectomy yuav txuas ntxiv mus rau kev txhim kho FPE tus nqi, thiab ua raws li txoj kev loj hlob thiab cov tshiab frontiers ntawm thrombectomy indications. Qhov tseem ceeb tshaj plaws ntawm cov no yog distal lossis nruab nrab vascular thrombectomy. Qhov no yuav xav tau ib txoj kab uas hla me me, tej zaum yuav qhib-voj stent tsim, nyob ib ncig ntawm MCA lub hauv caug, thiab ntau dua tortuous thiab me txoj kab uas hla M2 thiab M3 ntu uas tuaj yeem muab cov khoom siv traction thiab radial quab yuam.
Cov lus qhia yav tom ntej rau hom kev tshawb fawb no yuav tsum sib piv cov stents ntawm qhov loj me thiab kev faib ua ke nrog ib leeg thiab tejzaum nws kuj tseem tshawb xyuas qhov kev xav tau ncaj qha raws li kev sib txuas rau stent retriever siv txhawm rau txhawm rau txheeb xyuas cov txiaj ntsig zoo ntawm cov txheej txheem Solumbra. Lub stent retriever nyob rau hauv feem ntau cov kev tshawb fawb tau hloov kho los ntawm cov neeg muab khoom, yog li nws tseem muaj txiaj ntsig los hloov kho cov ntaub ntawv nrog cov pov thawj tshiab. Kev tshawb fawb tsiaj sib piv ntawm stents kuj tseem ceeb rau cov kws kho mob.