Solumbra Technique yog dab tsi?
Qhov sib txawv tseem ceeb ntawm kev hloov lub tswv yim thiab cov txheej txheem Solumbra yog raws li hauv qab no. Hloov nws tus kheej yog lub tswv yim uas siv ib lub cuab yeej thiab tom qab ntawd hloov mus rau lwm qhov hauv qee kis. Txawm li cas los xij, Solumbra yog cov txheej txheem uas siv ob txoj hauv kev ib txhij. Ua ntej, ib qho kev qhia catheter yog nkag mus rau hauv qhov ze ntawm lub hom phiaj cov hlab ntsha. Tom qab ntawd, 2.3 Fabkis lossis 2.5 Fabkis txoj microcatheter nrog rau 0.014 nti lossis 0.016 nti microguide hlau sab hauv yog pub rau hauv lub raj xa dej. Raws li ib tug tag nrho system yog advanced mus rau hauv lub guiding catheter. Tseem ceeb, raws li ib feem tshwj xeeb thev naus laus zis ntawm Solumbra, los ntawm cov kauj ruam no lub microcatheter yog threaded los ntawm thrombus. Tom qab ntawd, ua ntej lub clot extraction ntaus ntawv kom ze rau lub thrombus li sai tau. Tom qab ntawd lub thrombectomy stent raug tso tawm ntawm thrombus ntawm microcatheter. Tom ntej no, lub microcatheter raug tshem tawm tag nrho. Tom qab ib tug txheej txheem tos lub sij hawm ntawm 3-5 feeb, txuas lub aspiration catheter mus rau ib tug 50 mL syringe rau phau ntawv aspiration los yog nqus twj tso kua mis, siv tsis zoo siab mus rub lub thrombectomy stent retrieval rau hauv lub aspiration catheter, thiab nce mus rau hauv lub thrombus ib txhij. . Yog hais tias lub thrombus yuav nyob nruab nrab ntawm lub ntsis ntawm revascularization Device thiab lub aspiration catheter, ua tib zoo tshem tawm lub system tag nrho nrog tas li aspiration thaum manually aspirating los ntawm cov qhia catheter.
Solumbra thev naus laus zis tuaj yeem muab ntau qhov kev sib koom ua ke uas ua ke nrog kev siv lub thrombectomy stent thiab aspiration catheter. Kev xav hauv zos ntawm thrombus tuaj yeem pab txhawb nqa lub thrombus hauv lub stent. Kev tswj cov ntshav ntws hauv thaj tsam ntawm cov hlab ntsha tuaj yeem txo qhov tshwm sim ntawm thrombus fragmentation thiab distal embolism. Qhov no tau pom nyob rau hauv 7.9 feem pua ntawm cov neeg mob hauv SWIFT thiab TREVO kev sim thiab tau siab txog 11 feem pua hauv cov npe tom ntej. Tshem tawm cov microcatheter los ntawm cov khoom siv clot extraction tawm ntawm qhov chaw hla qhov chaw ntau dua rau kev nqus ntawm cov thrombus, yog li ua kom cov aspirating ntau tuaj yeem siv tau thaum muab cov thrombus stent retrieval.
Muaj ntau qhov xwm txheej thiab kev tshawb fawb soj ntsuam ntsig txog cov txheej txheem Solumbra. Thawj cov ntaub ntawv qhia txog kev sau ntawv tuaj yeem rov qab mus rau xyoo 2013. Hauv tsab ntawv tshaj tawm no, cov kws sau ntawv piav qhia txog cov txheej txheem rau kev xa cov stent los ntawm lub tshuab nqus tsev nqus tsev vacuum siv 6-Fabkis triaxial system los muab intracranial aspiration nyob ib ncig ntawm lub stent. Yog li ntawd, qhov tsis zoo siab aspiration thiab ntws occlusion yuav tsum tau ua los ntawm kev siv BGC kom txo tau qhov kev pheej hmoo ntawm thrombus khiav los ntawm stent retrieval ntaus ntawv los ntawm antegrade ntshav txaus. Cov txheej txheem stems los ntawm qhov tseeb hais tias tsuas yog ib tug vertebral hlab ntsha yog nkag tau rau hauv lub vertebrobasilar system thiab yuav tsum tau txaus aspiration.
Lwm daim ntawv tshaj tawm qhia tias Solumbra kuj tseem siv tau rau ICA davhlau ya nyob twg occlusion. Cov kws sau ntawv tau tshawb xyuas qhov ua tau ntawm kev sib txuas cov stent retrieval thiab aspiration thrombectomy kom muaj txiaj ntsig zoo dua ntawm kev mob ICA davhlau ya nyob twg occlusion. Kaum tus neeg mob sib law liag nrog mob ICA davhlau ya nyob twg occlusion kho nrog cov txheej txheem Solumbra tau txheeb xyuas. TICI 2 lossis 3 recanalization tau ua tiav hauv 80 feem pua ntawm cov neeg mob. Txawm li cas los xij, ICH tau tshwm sim hauv 4 tus neeg mob thiab tsis muaj hom 2 parenchymal hematoma tau pom. Plaub ntawm 10 tus neeg mob tuag hauv 3 lub hlis. Nyob rau hauv 2015, ib tug multicenter retrospective tshuaj xyuas ntawm cov txheej txheem Solumbra tau ua nyob rau hauv lub tebchaws United States. 105 tus neeg mob uas tau ntsib nrog cov txheej txheem suav nrog rau qhov kev tshawb fawb rov qab no, TICI qib 2b lossis 3 recanalization tau ua tiav hauv 88 feem pua. Tsis tas li ntawd, 44 feem pua ntawm cov neeg mob tau txais txiaj ntsig zoo ntawm 90 hnub. Tsib kis ntawm cov tsos mob ICH tau tshaj tawm, nrog rau peb tus txheej txheem ntsig txog kev tuag. Lawv xaus lus tias cov txheej txheem Solumbra yuav yog ib qho zoo thiab muaj kev nyab xeeb rau kev siv tshuab thrombectomy rau cov hlab ntsha loj occlusions. Txawm hais tias muaj qee cov lus ceeb toom qhia cov txiaj ntsig los ntawm Solumbra thev naus laus zis, qhov no tseem muaj qhov tsis sib haum xeeb. Piv txwv li, nyob rau hauv ib daim ntawv 2015 hu ua "Kev sib piv ntawm Clinical Outcomes nyob rau hauv cov neeg mob nrog mob Ischemic Stroke kho nrog Mechanical Thrombectomy Siv Solumbra los yog ADAPT Technique," ADAPT cov txheej txheem tau zoo dua kev soj ntsuam ntawm 90 hnub nyob rau hauv cov neeg mob stroke piv nrog rau cov neeg mob mob ischemic stroke piv rau. Cov neeg mob siv Solumbra.