Kirish
Aspiratsion trombektomiya o'tkir ishemik insultni davolashda keng qo'llaniladigan protsedura bo'lib, kateter hajmini tanlash ushbu protseduraning muhim jihati hisoblanadi. Aspiratsiya kateterining kattaligi trombektomiya samaradorligiga va protsedura xavfsizligiga ta'sir qiladi. Katta o'lchamdagi kateter trombni olib tashlash imkoniyatini oshirishi mumkin, ammo tomir shikastlanishi va distal embolizatsiya xavfini oshirishi mumkin. Aksincha, kichik kateter o'lchami xavfsizroq bo'lishi mumkin, ammo pıhtıyı olib tashlashda samarasiz bo'lishi mumkin. Ushbu maqolada biz aspiratsiya kateteri hajmining aspiratsion trombektomiyadagi klinik natijalarga ta'sirini ko'rib chiqamiz.
Kateter o'lchami - optimal o'lcham nima?
Aspiratsion trombektomiya uchun optimal kateter hajmi munozara mavzusi bo'lib, turli ishlab chiqaruvchilar kateterning turli o'lchamlarini taqdim etadilar. Hozirgi tadqiqotlar shuni ko'rsatadiki, kateterning o'lchami intrakranial tomir hajmiga, qon ivishining yukiga va garov holatiga qarab belgilanishi kerak. Umuman olganda, kattaroq kateter o'lchami kattaroq tomirlar va yuqori qon ivishi uchun afzallik beriladi, kichikroq kateter esa kichikroq tomirlar va quyi tromb yuki uchun ishlatiladi.
Kateter hajmining revaskulyarizatsiya tezligiga ta'siri
The revascularization rates are crucial in aspiration thrombectomy, and catheter size is a significant factor affecting this outcome. Studies have shown that a larger catheter size is associated with higher revascularization rates. For example, a study by Turk et al. found that the revascularization rate was 57.1% for a 5F catheter and 75% for a 6F catheter. Similarly, a study by Nambiar et al. found that a larger catheter size (>5.5F) yuqori birinchi o'tish reperfuziya tezligi bilan bog'liq edi.
Kateter hajmining reperfuziyaga ta'siri
Time to reperfusion is another crucial outcome in aspiration thrombectomy. Studies have shown that a larger catheter size is associated with shorter time to reperfusion. For example, a study by Turk et al. found that the time from groin puncture to reperfusion was shorter with a 7F catheter than with a 5F catheter (37.4 min vs. 50.5 min). Similarly, a study by Turk et al. found that the time to reperfusion was shorter with a larger catheter size (>5,5 F). Vaqt muhim bo'lgan o'tkir ishemik insultda bu natija juda muhimdir.
Kateter o'lchamining xavfsizlikka ta'siri
Safety is another critical aspect of aspiration thrombectomy, and larger catheter sizes may increase the risk of complications. Studies have shown that a larger catheter size is associated with more vessel injury, distal embolization, and hemorrhagic transformation. For example, a study by Ciccio et al. found that a 6F catheter was associated with a higher incidence of dissection (16.7%) than a 5F catheter (3.6%). Similarly, a study by Nambiar et al. found that a larger catheter size (>5.5F) distal embolizatsiyaning yuqori chastotasi bilan bog'liq edi.
Xulosa
Umuman olganda, aspiratsion kateter hajmi aspiratsiya trombektomiyasida muhim omil bo'lib, samaradorlik va xavfsizlik natijalariga ta'sir qiladi. Kateterning optimal o'lchami intrakranial tomir o'lchamiga, qon ivishining yukiga va garov holatiga qarab tanlanishi kerak. Tadqiqotlar shuni ko'rsatdiki, kattaroq kateter o'lchami yuqori revaskulyarizatsiya tezligi va reperfuziya vaqtining qisqarishi bilan bog'liq. Biroq, kattaroq kateter o'lchamlari tomir shikastlanishi, distal embolizatsiya va gemorragik transformatsiya kabi asoratlar xavfini oshirishi mumkin. Shuning uchun kateter hajmini tanlash bemorni va protsessual omillarni hisobga olgan holda diqqat bilan ko'rib chiqilishi kerak.