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Evaluation of the Intracranial Flow Alteration during Manual Syringe and Continuous Pump Aspiration

Authors
 Hideo Okada  ;  Yoshikazu Matsuda  ;  Alex Malisch  ;  Joonho Chung  ;  Daniel M. Heiferman  ;  Demetrius K. Lopes 
Citation
 JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, Vol.28(9) : 2574-2579, 2019 
Journal Title
 JOURNAL OF STROKE & CEREBROVASCULAR DISEASES 
ISSN
 1052-3057 
Issue Date
2019
Keywords
Balloon guide catheter ; aspiration ; mechanical thrombectomy ; stroke
Abstract
GOALS: While mechanical thrombectomy (MT) has been shown to be effective in the treatment of acute large vessel occlusions, adjunctive measures, such as balloon guide catheters (BGC) and aspiration techniques, are utilized heterogeneously. Clarifying the effects of aspiration applied to the anterior cerebral circulation with proximal flow arrest can shed light on embolic protection during MT. MATERIALS AND METHODS: Manual and pump aspiration were applied through a BGC in a synthetic cerebrovascular model with a 60 ml syringe and a Penumbra pump, respectively. Flow direction was observed during the procedure with fluorescent particles and ultraviolet light. Flow rates were monitored at the simulated internal carotid artery and middle cerebral artery (MCA). FINDINGS: Both aspiration methods produced retrograde flow in all the modeled cerebrovascular segments. In the syringe aspiration methods, an interval phase occurred during the experimental trial in which suction forces paused and MCA flow became anterograde through posterior communication artery collateral circulation. CONCLUSION: Flow patterns vary with different methods of aspiration. With proximal flow arrest, continuous aspiration methods induce constant retrograde flow in all vessels, whereas manual aspiration demonstrates various flow changes, including periods of anterograde flow during the procedure, which may be less effective at distal re-embolization prevention.
Full Text
https://www.sciencedirect.com/science/article/pii/S1052305719302356
DOI
10.1016/j.jstrokecerebrovasdis.2019.05.015
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Chung, Joon Ho(정준호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173215
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