Yilmaz Onal
"Hybrid" originally means "hybrid", "hybrid". The design, characteristics and model combination of Hybrid micro guide wire are made of mixed metal material, with comprehensive models and excellent performance, and have been highly recognized by experts at home and abroad.
Hybrid材质设计Material & Design
- Stainless steel guidewires are stiff and can provide better torsion control and support, but will increase the risk of intracranial vascular injury, while nickel-titanium guidewires can provide better compliance, safety and moldability, but lack of support and torsional control.
- The hybrid micro guide wire is a hybrid of proximal stainless steel and distal nickel-titanium, and the two are seamlessly connected through intelligent welding technology, which has the advantages of both materials - "rigidity and softness"
Hybrid性能优势Feature & Advantage
Hybrid型号选择Part Numbers
A wide range of micro guidewire models
- 007&008 - the world's thinnest micro guidewire
- 10D&12D 300——310cm更长的交换微导丝
- 1214D/DA+14D – a more comprehensive treatment option
Preface
Considering the risk of hemorrhagic transformation after distal thrombectomy [1], Chinese and foreign surgeons are looking for more optimal techniques to reduce the associated risks. Combined with the experience of over-selection of distal small blood vessels in AVM treatment, Hybrid 008 microguidewire may be an option in DMVO treatment with both distal in-place ability, microcatheter support and safety due to its thin outer diameter and soft tip. A case is shared as follows:
01. Case information
Patient: Male, 77 years old.
Chief complaint: 2 hours of symptomatic onset, NIHSS score 16.
02. Image information
Contrast showed embolization of the distal position of M2 in the superior trunk of the middle cerebral artery.
03. Surgical consumables
- Hybrid 008微导丝
- 17 microcatheters
- Catchview Mini取栓支架
04. Treatment process
How can I reduce the risks associated with microguidewire manipulation?
Hybrid 008微导丝!!
The J-shaped tip of the Hybrid 008 microguidewire can be easily arched dorsally in a small diameter vessel distal to M2.
, duration 00:21
The Hybrid 008 guidewire passes through the thrombus location with 17 microcatheters in place.
Contrast confirms the true lumen of the blood vessels.
Release the Catchview Mini thrombectomy stent through 17 microcatheters.
The thrombectomy is retracted until the microcatheter orifice is against the proximal end of the thrombus, and thrombectomy is performed by a clamping technique [2].
M2 upper stem distal end re-pass.
CT showed no bleeding 24 hours after surgery, and the NIHSS score decreased from 16 to 7.
bibliography
[1] Bilgin C, Hardy N, Hutchison K, et al. First-line thrombectomy strategy for distal and medium vessel occlusions: a systematic review. Journal of NeuroInterventional Surgery 2023;15:539-546.
[2] Velioglu M, Onal Y, Agackiran A, et al. Initial experience with the CatchView thrombectomy device for acute ischemic stroke. Journal of NeuroInterventional Surgery 2021;13:946-950.
Operator's profile
A.Prof. Yilmaz Onal,MD
Istanbul, Turkey
Fatih Sultan Mehmet Training and Research Hospital
(Fatih Sultan Mohammed Education and Research Hospital)
- MD, Associate Professor
- Interventional neuroradiologist
- Member of the European Society for Minimally Invasive Neurotherapy (ESMINT).
- Member of the European Society of Cardiovascular and Interventional Radiology (CIRSE).
- Member of the Turkish Society of Neuroradiology, Society of Interventional Radiology, Society of Radiology
- JNIS reviewer
- Graduated from Ankara University Faculty of Medicine, Turkey
- He studied with Prof. Rene Chapot in Essen, Germany
Comments
Procedure-related bleeding during DMVO thrombectomy is mainly concentrated in two links: distal target vessel overselection & thrombectomy stent pullback. In the former, the device punctures the blood vessel and causes bleeding, while in the latter, the stent pulls the vascular branch and breaks it and causes the bleeding. In the process of distal overselection, the most common is vascular puncture caused by guidewires.
In this case, Professor Yilmaz Onal chose Hybrid 008 microguidewire as the working guidewire for distal branch superselection, which is soft and slender enough, easy to shape and stable at the tip, and can be safely looped in the blood vessels, guiding the stent microcatheter in place, which greatly reduces the risk of guidewire puncture, which is worth learning.