Technical considerations and application scenarios for a novel thrombectomy technique (SPACEMAN): a prospective study

First author : Wu Yingchun ¹

Corresponding author : Wu Yingchun

Other authors : Wang Junmei, Sun Rui, Feng Guanqing, Li Wenzhao, Guiyuejiang, Zheng Yanan

Author unit : Department of Neurology, Ordos Central Hospital

Fund Project : Innovative Talent Team of Ordos Industrial Park

[REF: Wu Y, Wang J, Sun R, Feng G, Li W, Gui Y and Zheng Y (2022) A Novel Endovascular Therapy Strategy for Acute Ischemic Stroke Due to Intracranial Atherosclerosis-Related Large Vessel Occlusion: Stent-Pass-Aspiration -resCuE-micowire-Angioplasty (SPACEMAN) Technique.
Front.
Neurol.
13:798542.
doi: 10.
3389/fneur.
2022.
798542

Research Background

Mechanical thrombectomy has been the standard treatment for cerebral infarction caused by acute large vessel
occlusive disease .

Introduction to SPACEMAN Technology

① Deploy the stent and place the suction catheter on the thrombus ;

② The suction catheter is placed at the distal end of the stent through the thrombus;

③Under the condition that the position of the suction catheter is not changed, the stent is removed by suction with negative pressure;

④ The micro-guide wire is guided through the occluded lesion to the distal end under the guidance of the suction catheter;

⑤ After the suction catheter is withdrawn to the proximal end of the occlusion, angiography is performed;

⑥ Balloon or stent angioplasty
.

Research content and conclusions

way method

Patients: From January 2017 to June 2021, a total of 44 patients with large vessel occlusion caused by ICAS lesions diagnosed before and during the neurology department of Ordos Central Hospital were enrolled.
They were randomly divided into SPACEMANZ group (22 cases).
Solumbra group (22 cases)
.

Results show (Table 1)

• Mechanical thrombectomy was performed in 44 patients with acute ischemic stroke
  (32 males and 12 females; mean 58.
  
  93±9.
  
  The results show (Table 2)

  41 patients achieved reperfusion (recanalization rate: 93.
  18%)
  .

  
  In the SPACEMAN group, reperfusion was successfully achieved in 95.
  
  statistics

  This study proves that this novel thrombectomy technique (SPACEMAN technique), which combines aspiration catheter, stent thrombectomy and salvage techniques, is safe and effective for large vessel occlusive lesions caused by ICAS lesions
  .
  

  Typical case presentation

  The patient, male, 49 years old, was admitted to the hospital mainly because of "12 hours of left limb numbness and 6 hours of left limb hemiplegia"
  .

  
  NIHSS: 10 points
  
  

  ① DWI of the head: watershed infarction in the right cerebral hemisphere;

  ②DSA: occlusion at the beginning of the right MCA-M1 segment;

  ③ SPACEMAN technology:

  ③(A) The suction catheter was placed near the occlusion segment, and the stent was released after the microcatheter confirmed the true lumen

  
  

  ③(B) Place the suction catheter at the distal end of the stent under manual negative pressure, and withdraw the stent while keeping the position of the suction catheter unchanged

  
  

  ③(C) Under the guidance of the suction catheter, a 300 cm micro-guide wire was placed at the distal end of the MCA-M2 segment

  ③(D) The angiography showed severe stenosis of M1 after the suction catheter was withdrawn to the proximal end of the occlusion

  ③(E) Under the guidance of a suction catheter, the balloon-expandable stent is sent to the stenotic segment for dilation

  ③(F) DSA after angioplasty showed complete recanalization

  
  
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