ADAPT thev naus laus zis (A Direct Aspiration first-Pass Technology, ADAPT) yog ib txoj kev kho mob endovascular uas siv ncaj qha aspiration li thrombectomy technology. Cov txheej txheem no yuav tsum tau ncaj qha aspiration thrombectomy siv lub traceable, loj-bore aspiration catheter.
Hauv xyoo 2015, tsib qhov kev sim tshuaj endovascular stroke tseem ceeb tau tshaj tawm, lees paub tias cov neeg mob stroke tshwm sim los ntawm cov hlab ntsha loj occlusion tuaj yeem tau txais txiaj ntsig los ntawm kev kho mob endovascular. Qhov kev kawm tseem ceeb no tau tsim tsa lub luag haujlwm ntawm txhua yam thrombectomy hauv cov hlab ntsha loj occlusion. Cov xwm txheej ntawm thawj kab kev kho mob qhia txog qhov tuaj txog ntawm lub sijhawm ntawm thrombectomy.
Hauv ob xyoos dhau los, nrog kev tshwm sim ntawm ADAPT thev naus laus zis, stent retriever thrombectomy lossis aspiration catheter tau dhau los ua lub ntsiab lus kub uas tau tham dav dav hauv kev kho mob. 2019 AHA/ASA cov lus qhia hloov tshiab teev ADAPT thev naus laus zis raws li IB tau pom zoo kho, muab cov pov thawj muaj zog txhawb rau kev siv tshuaj kho mob ntawm ADAPT thev naus laus zis.
Cov txiaj ntsig tshawb fawb pom tau tias 78% ntawm cov neeg mob tuaj yeem ua tiav aTICI qib 2b/3 ntshav ntws rov tsim kho siv ADAPT thev naus laus zis ib leeg. Yog tias ua ke nrog stent thrombectomy thev naus laus zis, qhov zoo tshaj plaws recanalization tuaj yeem nce ntxiv mus rau 95%.
Qhov txiaj ntsig tseem ceeb ntawm ADAPT thev naus laus zis yog kev ua haujlwm yooj yim dua, lub sijhawm qhib luv luv, qis los ntshav, muaj kev nyab xeeb siab, nce kev faib ua feem thib peb, thiab txo cov kev khiav tawm ntawm qhov distal embolus.
Txoj kab uas hla ntawm lub ntsiab nqus catheter feem ntau siv hauv kev kho mob yog nyob nruab nrab ntawm 0.068"-0.072". Lub cim tshiab aspiration catheter tau txuas ntxiv txhim kho nws qhov chaw muaj peev xwm thiab tuaj yeem raug thawb ncaj qha mus rau hauv txoj haujlwm. Aspiration thev naus laus zis tsis tsuas yog ua tiav cov txiaj ntsig zoo hauv kev qhib thrombotic occlusions nyob rau hauv cov hlab ntsha loj, tab sis kuj qhia tau hais tias muaj kev sib raug zoo hauv cov hlab ntsha nruab nrab ntau dua.
Rau cov neeg mob uas muaj qhov loj thrombus load (xws li qhov kawg ntawm ICA), tandem lesions, thiab posterior circulation lesions, qhov zoo ntawm thrombectomy los ntawm aspiration catheter yog pom tseeb heev. 2. Rau cov neeg mob uas muaj cov hlab ntsha nruab nrab cerebral embolism, yog tias lub microcatheter thiab microguidewire tsis tas yuav dhau los ntawm qhov txhab, lawv tsuas yog yuav tsum nqa lub nqus catheter ncaj qha mus rau thrombus ze ze rau qhov txhab. Nyob rau hauv rooj plaub no, ncaj qha aspiration thiab thrombectomy yuav raug txiav txim siab. 3. Rau cov neeg mob uas muaj stenotic lesions, aspiration thiab thrombectomy tsis nyiam. Xav txog cov kev txwv ntawm proximal stenosis, lub distal thrombus yog ib qho nyuaj rau aspirate.
Direct thrombus aspiration thev naus laus zis tau dhau los ua lub ntsiab lus qhib thev naus laus zis nrog rau stent thrombectomy nyob rau hauv mob intracranial loj hlab ntsha occlusion thrombectomy. Txhua qhov chaw muaj qhov tshwj xeeb nyiam thiab tuaj yeem siv ib leeg lossis sib xyaw ua ke raws li vascular occlusion thiab vascular mob. Qee cov kws tshaj lij ntseeg tias tam sim no kev siv lub tshuab nqus tsev loj loj nruab nrab catheter ncaj qha aspiration thev naus laus zis (ADAPT) muaj tus nqi rov qab ntau dua thiab lub sijhawm qhib luv dua li stent retriever thrombectomy. Nrog rau kev txhim kho cov ntaub ntawv, kev hloov tshiab ntawm kev tshawb fawb, thiab kev txhawb nqa ntawm cov khoom siv hauv tsev, ADAPT thev naus laus zis tuaj yeem dhau los ua qhov sib txawv hauv kev kub ntxhov ceev.