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Commonly Used Devices for Neurointerventional Therapy
Neurovascular interventional radiotherapy refers to the treatment of certain diseases of the central nervous system through arterial or venous routes under X-ray monitoring.
Endovascular neurosurgery has developed rapidly in the past years, imaging, embolic materials and embolization techniques have been continuously improved, and the results of treatment have been continuously improved. Choosing the right material can make the treatment safer and more effective, so we should have some knowledge about the relevant materials of interventional treatment.
At present, there are a large number of different types of interventional materials to choose from on the market, mainly including basic materials for angiography, superselective catheter guide wires, and interventional therapy materials.
1. Basic materials of angiography for neurovascular intervention
The puncture needle consists of a polyethylene outer sheath and an inner cannula of a stainless steel beveled needle.
The introducer sheath consists of an inner (vascular dilator), an outer cannula (vascular indwelling sheath), and a guide wire. The side wall of the outer cannula has a connecting tube for connecting a pressurized drip container to prevent thrombosis in the catheter sheath. High-flow contrast catheters 4 to 6 are appropriate, mainly used for angiography, and sometimes also used as guiding catheters.
Ordinary guide wire: It is used in conjunction with the contrast catheter to facilitate access to tortuous blood vessels for selective angiography.
Auxiliary materials: tee, pressurized bag and Y-shaped hemostatic valve, etc.
Hemostatic sheath: It is used for hemostasis at the arterial puncture point after the operation, and can replace artificial compression hemostasis.
2. Catheter guide wire for neurovascular intervention
Guiding catheter: It is mainly used to selectively introduce neurovascular microcatheters. There are many types of 5-8F commonly used in clinical practice. Different types of guiding catheters, such as the balloon guiding catheter are selected according to the therapeutic purpose. Among them, the Enuoy catheter has a large lumen and a thin wall, and has good supporting force, so it is the most commonly used in nerve intervention.
Exchange guide wire: It is exchanged with the angiography catheter, which is used for the selective positioning of the guide catheter when the blood vessel is tortuous.
There are two main types of microcatheters:
①Blood flow guiding microcatheter. The driving force of this catheter is the flow of blood, and it is characterized by a soft and extremely buoyant tip of the microcatheter. It is mainly used to treat lesions with high blood flow, such as cerebral arteriovenous malformation, etc. The latter two types of microcatheters also have better guide wire guidance and are the most commonly used.
②Guide wire guiding microcatheter. The driving force of this catheter is mechanical force, and it is guided by a guide wire to accurately reach a lesion site such as an aneurysm cavity. The head end is mostly made of plasticable materials.
Micro-guide wire: used in conjunction with micro-catheter to guide the micro-catheter to precisely reach the lesion that needs to be treated.