Related Experiment Video
Updated: Aug 16, 2025
Simulator Training for Endovascular Neurosurgery
Published on: May 6, 2020
Preliminary experience with recanalization of large vessel occlusion due to underlying long-segment dissection using
Xiaoxi Zhang1, Hongye Xu1, Zhengzhe Feng1
1Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Insights
A novel standby microwire technique effectively revascularized large vessel occlusion in acute ischemic stroke patients with long-segment dissection. This method achieved 100% technical success and favorable outcomes without complications.
Area of Science:
- Interventional Neurology
- Vascular Neurology
- Medical Devices
Background:
- Emergent large vessel occlusion (ELVO) in acute ischemic stroke secondary to long-segment dissection presents complex revascularization challenges.
- Current endovascular techniques may require optimization for managing these specific anatomical difficulties.
Purpose of the Study:
- To investigate the efficacy and safety of a novel standby microwire technique for facilitating revascularization in ELVO caused by long-segment dissection.
- To evaluate the technical success and clinical outcomes associated with this approach.
Main Methods:
- Retrospective analysis of clinical and radiological data from patients with acute ischemic stroke and ELVO due to long-segment dissection treated between January 2021 and May 2022.
- Application of a standby microwire technique during endovascular treatment, including stent deployment.
- Assessment of groin puncture to reperfusion times and technique-related complications.
Main Results:
- The standby microwire technique was utilized in five patients (aged 33-55) with ELVO from long-segment dissection.
- Technical success and favorable clinical outcomes were achieved in all five patients (100%).
- No technique-related complications were observed, with groin puncture to reperfusion times ranging from 10-68 minutes.
Conclusions:
- The standby microwire technique is a valuable ancillary approach for improving revascularization in large vessel occlusion secondary to long-segment dissection.
- This preliminary experience suggests the technique is safe and effective in this challenging patient subset.
Purpose:
This study aimed at investigating a novel standby microwire technique to facilitate revascularization of large vessel occlusion due to underlying long-segment dissection.
Methods:
Patients with acute ischemic stroke with emergent large vessel occlusion (ELVO) due to underlying long-segment dissection were screened from the prospectively established database between January 2021 and May 2022. The clinical and radiological data of eligible patients who underwent endovascular treatment by using a standby microwire technique were investigated.
Results:
Of the 165 acute ischemic stroke patients who underwent mechanical thrombectomy, the standby microwire technique was used in five patients aged 33-55 years old with occlusion due to underlying long-segment dissection. Of them, three patients were diagnosed with tandem lesions and three were located at the anterior circulation. A 300 cm exchange microwire was used as the standby microwire. Stent deployment was performed in all five patients. Groin puncture to reperfusion time ranged from 10-68 min. Technical success and favorable clinical outcomes were achieved in all five patients (100%). No technique-related complication was observed.
Conclusion:
Our preliminary experience showed that the standby microwire technique was a useful ancillary approach to facilitate the revascularization of large vessel occlusion due to underlying long-segment dissection.
