Preliminary application of the Syphonet stent distal protection technique in recanalization of chronic long-segment occlusion of intracranial and extracranial artery
Objective To observe the effect of Syphonet stent on distal protection in recanalization of chronic intracranial and extracranial long-segmental artery occlusion(CIEAO).Methods The clinical data of 9 patients with CIEAO who underwent recanalization at the Department of Cerebrovascular Disease,Henan Provincial People's Hospital from November 2022 to April 2023 were retrospectively analyzed.The Syphonet stent was used as the distal protection device during the operation in all patients.Successful recanalization of vessels was defined as modified thrombolysis in cerebral infarction(mTICI)≥ 2b.The surgical procedure and surgery-related complications were documented.Cranial imaging examination was performed at 6 months after the operation to evaluate vascular recanalization;the modified Rankin Scale(mRS)was used to evaluate the outcomes of patients.Results All 9 patients achieved successful recanalization.The median number of stents placed was 2(1-4),all stents adhered to the vascular wall well,and the operation time was 176(120-220)minutes.During the perioperative period,1 patient had intraoperative thrombus escape,which entered the Syphonet distal protection device and was successfully retrieved.At 6 hours post operation,1 patient had cerebral hemorrhage(possibly hemorrhagic transformation after subacute cerebral infarction),and there was no death cases.At 6-month follow-up after the procedure,1 patient was lost to follow-up;imaging evaluation showed in-stent vessel reocclusion in 2 patients and no in-stent vessel stenosis in the remaining patient.The mRS score was 0 in 5 cases,1 in 1 case,2 in 1 case,and 3 in 1 case.Conclusions The application of Syphonet stent distal protection technique in recanalization of CIEAO has a high technical success rate,which can capture the escaped thrombus and reduces the complications caused by thrombus detachment.In-stent restenosis or occlusion needs further study.
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