Aspiration Thrombectomy
Nrog rau kev tsim kho tshiab ntawm intracranial thrombus aspiration system, cov thev naus laus zis cuam tshuam ntawm thrombus aspiration tseem tab tom txhim kho sai. Cov neeg sawv cev thev naus laus zis yog FAST thiab ADAPT. DH Kang thiab lwm tus neeg thawj zaug siv FAST thev naus laus zis rau thrombectomy hauv xyoo 2011. Ua raws li cov txheej txheem FAST, Turk lwm tus neeg thawj zaug tau tshaj tawm cov txheej txheem ADAPT hauv xyoo 2013. Cov txiaj ntsig ntawm qhov kev tshawb fawb rov qab tau pom tias ADAPT yog ib txoj hauv kev yooj yim, siv tau zoo thiab kev lag luam rau thrombectomy, uas tuaj yeem siv los ua ib txoj hauv kev thawj zaug rau kev txhim kho vascular. Txoj kev ADAPT zoo ib yam li FAST. Thaum tshem tawm cov thrombus thawj zaug, lub aspiration catheter yog siv los mus ze lub thrombus thiab tshem tawm tag nrho. Nws yog qhov txawv ntawm cov txheej txheem yav dhau los ntawm kev siv lub tshuab cais los rhuav tshem cov thrombus ntawm qhov kawg ntawm lub catheter lumen. ADAPT cov txheej txheem txo tus naj npawb ntawm thrombectomy xav tau rau reperfusion. Hauv xyoo 2017, D. Wei thiab lwm tus neeg tau soj ntsuam 16 qhov kev tshawb fawb rov qab ntawm ADAPT thiab pom tias tus nqi rov qab mus txog 89.3 feem pua ntawm kev siv ADAPT, uas tau txheeb xyuas qhov zoo ntawm vascular recanalization tus nqi ntawm ADAPT thev naus laus zis. Hauv xyoo 2018, Aquila thiab lwm cov kws tshawb fawb tau tshaj tawm txog 2-xyoo yav tom ntej, randomized, ob leeg dig muag tswj kev sim (COMPASS) los sib piv cov kev kho mob ntawm ADAPT thiab stent retriever thrombectomy. Thaum 90 hnub, cov txiaj ntsig kho tsis muaj tsawg dua li ntawm thrombectomy nrog stent retrieval tuaj yeem ua tiav.
Aspiration Ua ke nrog Stent Retriever Thrombectomy
Xyoo 2013, Lee thiab lwm tus kws tshawb fawb tau siv thrombectomy stents thiab aspiration ua ke nrog txhua yam thrombectomy nyob rau hauv cov ntaub ntawv ntawm mob carotid artery terminal occlusion. Thiab 10 tus neeg mob tau kho thiab ua raws. Kev siv ua ke ntawm ob lub tshuab thrombectomy tuaj yeem txhim kho tus nqi ntawm cov hlab ntsha carotid termina occlusion. Kev sib xyaw ua ke ntawm ob txoj kev siv tau zoo. Qhov kev sib xyaw ua ke ntawm ob lub cuab yeej no hu ua "Solumbra" thev naus laus zis. Tsis tas li ntawd, muaj qee qhov kev sib koom ua ke nrog rau cov txheej txheem SAVE (stent retriever pab lub tshuab nqus tsev xauv thrombectomy), ARTS txheej txheem (stent retriever ntxiv rau nruab nrab catheter aspiration), ASAP txheej txheem (proximal balloon occlusion ua ke nrog thrombus aspiration). Kev hloov kho Solumbra thrombectomy cov txheej txheem siv lub distal intracranial catheter rau ib nrab-retract lub thrombectomy ntaus ntawv ua ntej thrombectomy kom luv lub sij hawm thrombectomy thiab txo endothelial puas. Dab tsi cov tswv yim no muaj nyob rau hauv kev sib xyaw ua ke ntawm stent retrieval thiab aspiration cov tswv yim, tag nrho cov uas txhua tus tau tshaj tawm ntau dua reperfusion tus nqi, siab dua thawj zaug recanalization tus nqi, qis thrombectomy lub sij hawm, thiab / los yog qis thrombus khiav tawm.