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Analysis of the Anatomical Factors Affecting Ability to Navigate Penumbra Catheter through Internal Carotid Siphon

OBJECTIVE: The efficacy and safety of aspiration thrombectomy using Penumbra catheter with acute large vessel occlusion in the anterior circulation have been reported in previous studies. In some cases, the carotid siphon (CS) is elongated, and with this anatomy, especially where there is bifurcatio...

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Autores principales: Kuriyama, Emi, Matsuda, Yoshikazu, Kawaguchi, Takumi, Yako, Rie, Nakao, Naoyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society for Neuroendovascular Therapy 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370674/
https://www.ncbi.nlm.nih.gov/pubmed/37502688
http://dx.doi.org/10.5797/jnet.oa.2020-0003
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author Kuriyama, Emi
Matsuda, Yoshikazu
Kawaguchi, Takumi
Yako, Rie
Nakao, Naoyuki
author_facet Kuriyama, Emi
Matsuda, Yoshikazu
Kawaguchi, Takumi
Yako, Rie
Nakao, Naoyuki
author_sort Kuriyama, Emi
collection PubMed
description OBJECTIVE: The efficacy and safety of aspiration thrombectomy using Penumbra catheter with acute large vessel occlusion in the anterior circulation have been reported in previous studies. In some cases, the carotid siphon (CS) is elongated, and with this anatomy, especially where there is bifurcation of the ophthalmic artery (OA), navigation of Penumbra catheters into distal internal carotid artery (ICA) is interrupted, which is known as the ‘ledge effect’. We investigate the anatomical characteristics of CS that cause interruption of navigation of the Penumbra catheter. METHODS: Between January 2015 and March 2018, mechanical thrombectomy using Penumbra 60 was performed on 51 patients with middle cerebral artery (MCA) or intracranial ICA occlusion. Patients were divided into two groups: The ‘ledge-effect’ group those in whom the Penumbra catheter was unable to be navigated into the distal ICA through the CS, and ‘no ledge-effect’ group those in whom this was possible. The anatomical characteristics of CS, the diameter of ICA, diameter of OA, OA/ICA ratio and radius of the CS were evaluated using angiographical imaging. RESULTS: The ‘ledge-effect’ group numbered eight cases (17%). Only the value of the CS radius was significantly smaller in the ledge-effect group (p = 0.0019), other parameters were not significantly different between the groups. The cutoff radius value was 3.62 mm. CONCLUSION: The most notable anatomical factor affecting possibility of navigation of the Penumbra catheter through the CS was the CS radius. This could be useful information when devices used in mechanical thrombectomy are selected.
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spelling pubmed-103706742023-07-27 Analysis of the Anatomical Factors Affecting Ability to Navigate Penumbra Catheter through Internal Carotid Siphon Kuriyama, Emi Matsuda, Yoshikazu Kawaguchi, Takumi Yako, Rie Nakao, Naoyuki J Neuroendovasc Ther Original Article OBJECTIVE: The efficacy and safety of aspiration thrombectomy using Penumbra catheter with acute large vessel occlusion in the anterior circulation have been reported in previous studies. In some cases, the carotid siphon (CS) is elongated, and with this anatomy, especially where there is bifurcation of the ophthalmic artery (OA), navigation of Penumbra catheters into distal internal carotid artery (ICA) is interrupted, which is known as the ‘ledge effect’. We investigate the anatomical characteristics of CS that cause interruption of navigation of the Penumbra catheter. METHODS: Between January 2015 and March 2018, mechanical thrombectomy using Penumbra 60 was performed on 51 patients with middle cerebral artery (MCA) or intracranial ICA occlusion. Patients were divided into two groups: The ‘ledge-effect’ group those in whom the Penumbra catheter was unable to be navigated into the distal ICA through the CS, and ‘no ledge-effect’ group those in whom this was possible. The anatomical characteristics of CS, the diameter of ICA, diameter of OA, OA/ICA ratio and radius of the CS were evaluated using angiographical imaging. RESULTS: The ‘ledge-effect’ group numbered eight cases (17%). Only the value of the CS radius was significantly smaller in the ledge-effect group (p = 0.0019), other parameters were not significantly different between the groups. The cutoff radius value was 3.62 mm. CONCLUSION: The most notable anatomical factor affecting possibility of navigation of the Penumbra catheter through the CS was the CS radius. This could be useful information when devices used in mechanical thrombectomy are selected. The Japanese Society for Neuroendovascular Therapy 2020-03-13 2020 /pmc/articles/PMC10370674/ /pubmed/37502688 http://dx.doi.org/10.5797/jnet.oa.2020-0003 Text en ©2020 The Japanese Society for Neuroendovascular Therapy https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Article
Kuriyama, Emi
Matsuda, Yoshikazu
Kawaguchi, Takumi
Yako, Rie
Nakao, Naoyuki
Analysis of the Anatomical Factors Affecting Ability to Navigate Penumbra Catheter through Internal Carotid Siphon
title Analysis of the Anatomical Factors Affecting Ability to Navigate Penumbra Catheter through Internal Carotid Siphon
title_full Analysis of the Anatomical Factors Affecting Ability to Navigate Penumbra Catheter through Internal Carotid Siphon
title_fullStr Analysis of the Anatomical Factors Affecting Ability to Navigate Penumbra Catheter through Internal Carotid Siphon
title_full_unstemmed Analysis of the Anatomical Factors Affecting Ability to Navigate Penumbra Catheter through Internal Carotid Siphon
title_short Analysis of the Anatomical Factors Affecting Ability to Navigate Penumbra Catheter through Internal Carotid Siphon
title_sort analysis of the anatomical factors affecting ability to navigate penumbra catheter through internal carotid siphon
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370674/
https://www.ncbi.nlm.nih.gov/pubmed/37502688
http://dx.doi.org/10.5797/jnet.oa.2020-0003
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