1.Ulnar artery access for intracranial mechanical thrombectomy procedure: A salvage option after failed trans-femoral and trans-radial access
Muhammad U MANZOOR ; Abdullah A ALRASHED ; Ibrahim A ALMULHIM ; Sultan ALQAHTANI ; Fahmi Al SENANI
Journal of Cerebrovascular and Endovascular Neurosurgery 2023;25(4):429-433
84 years old gentle man with past medical history of hypertension and diabetes presented with sudden onset right sided weakness and aphasia for two hours. Initial neurological assessment revealed National Institute of Health Stroke Scale (NIHSS) 17. Computed tomography (CT) scan demonstrated minimal early ischemic changes along left insular cortex with occlusion of left middle cerebral artery (MCA). Based on clinical and imaging findings, decision was made to perform mechanical thrombectomy procedure. Initially, right common femoral artery approach was utilized. However, due to unfavorable type-III bovine arch, left internal carotid artery could not be engaged via this approach. Subsequently, access was switched to right radial artery. Angiogram revealed small caliber radial artery, with larger caliber ulnar artery. Attempt was made to advance the guide catheter through the radial artery, however significant vasospasm was encountered. Subsequently, ulnar artery was accessed and successful thrombolysis in cerebral infarction (TICI) III left MCA reperfusion was achieved with a single pass of mechanical thrombectomy via this approach. Post procedure neurological examination demonstrated significant clinical improvement. Doppler ultrasound 48 hours after the procedure demonstrated patent flow in radial and ulnar arteries with no evidence of dissection.
3.Initial experience with Scepter Mini dual lumen balloon for embolization of cerebrovascular diseases
Muhammad U MANZOOR ; Ibrahim A. ALMULHIM ; Abdullah A. ALRASHED ; Shorog ALTHUBAIT ; Abdulrahman Y. ALTURKI ; Sultan M. AL-QAHTANI
Journal of Cerebrovascular and Endovascular Neurosurgery 2023;25(2):175-181
Objective:
Endovascular treatment of cerebrovascular diseases is often challenging due to small caliber, tortuous distal vessels. Several devices and techniques have evolved to overcome these challenges. Recently, a low profile dual lumen microballoon catheter, specifically designed for distal navigation is employed for neurovascular procedures. Due to its recent advent, scarce data is available on clinical utility and safety of Scepter Mini. The aim of this case series is to report our initial experience with Scepter Mini in the management of various cerebrovascular diseases.
Methods:
All interventional neurovascular cases performed using Scepter Mini between January 2020 till April 2021 were included. Data regarding patient demographics, procedural details and complications was retrospectively collected from patient’s electronic medical record and procedure reports.
Results:
Total twelve embolization procedures were performed in eleven patients, including six brain arteriovenous malformation, two dural arteriovenous fistula, one vein of Galen malformation and three hyper-vascular glomus tumor embolizations. All procedures were successfully performed with adequate penetration of the embolic agent. Complete embolization was performed in six procedures, while intended partial embolization was performed in the rest of procedures. Scepter Mini was solely used in ten procedures, however in the other two embolization procedures it was used as an additional conjunct tool to complete the intended embolization. No balloon related complication was observed in any procedure.
Conclusions
Scepter Mini dual lumen microballoon catheter is safe and feasible for delivery of liquid embolic agents for cerebrovascular embolization procedures.
4.Purification of Plasmodium and Babesia- infected erythrocytes using a non-woven fabric filter
Tao, Z.Y. ; Liu, W.P. ; Dong, J. ; Feng, X.X. ; Yao, D.W. ; Lv, Q.L. ; Ibrahim, U. ; Dong, J.J. ; Culleton, R. ; Gu, W. ; Su, P.P. ; Tao, L. ; Li, J.Y. ; Fang, Q. ; Xia, H.
Tropical Biomedicine 2020;37(No.4):911-918
The purification of parasite-infected erythrocytes from whole blood containing
leucocytes is crucial for many downstream genetic and molecular assays in parasitology.
Current methodologies to achieve this are often costly and time consuming. Here, we
demonstrate the successful application of a cheap and simple Non-Woven Fabric (NWF) filter
for the purification of parasitized red blood cells from whole blood. NWF filtration was
applied to the malaria-parasitized blood of three strains of mice, and one strain of rat, and to
Babesia gibsoni parasitized dog blood. Before and after filtration, the white blood cell (WBC)
removal rates and red blood cell (RBC) recovery rates were measured. After NWF filter
treatment of rodent malaria-infected blood, the WBC removal rates and RBC recovery rates
were, for Kunming mice: 99.51%±0.30% and 86.12%±8.37%; for BALB/C mice: 99.61%±0.15%
and 80.74%±7.11%; for C57 mice: 99.71%±0.12% and 84.87%±3.83%; for Sprague-Dawley rats:
99.93%±0.03% and 83.30%±2.96%. Microscopy showed WBCs were efficiently removed from
infected dog blood samples, and there was no obvious morphological change of B. gibsoni
parasites. NWF filters efficiently remove leukocytes from malaria parasite-infected mouse
and rat blood, and are also suitable for filtration of B. gibsoni-infected dog blood.