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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 |
doi: 10.3389/fneur.2025.1508976
A single-center retrospective study of the Dual-channels Bolus Contrast Injection (Dc-BCI) technique during endovascular mechanical thrombectomy in the management of acute large vessel occlusions: a technical report
Provisionally accepted- 1 Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- 2 Shanghai Changzheng Hospital, Huangpu, Shanghai Municipality, China
- 3 Quzhou Hospital of Traditional Chinese Medicine, Quzhou, China
- 4 Shanghai Fourth People's Hospital, Shanghai, China
Endovascular mechanical thrombectomy (EMT) is an effective treatment for acute ischemic stroke and identifying the precise thrombus size remains key to a successful EMT. However, no imaging modality has been able to provide this information simultaneously and efficiently in an emergency setting. The present study introduces a novel technique named dual-channel bolus contrast injection (Dc-BCI) for determining thrombus size and location during EMT. In the in vitro study, the Dc-BCI demonstrated an accurate projection of the thrombus size, as the actual thrombus diameter (R²=0.92, P<0.01) and length (R²=0.94, P<0.01) exhibited a high degree of correlation with that of obtained from Dc-BCI. Consequently, between February 2023 and August 2024, 87 patients diagnosed with acute cerebral large vessel occlusions were enrolled in the study and received EMT for the treatment of acute cerebral large vessel occlusions. The Dc-BCI was successfully performed in all patients to measure the diameter and length of the thrombus. These information were used to select an appropriate stent-retriever for EMT.The restoration of blood flow was achieved in 84 patients (96.6%) to an mTICI score of 2b/3. Additionally, a low incidence of postoperative complications was observed (e.g. subarachnoid hemorrhage 8% and cerebral hemorrhage 5.7%). In conclusion, it can be posited that the Dc-BCI has the potential to enhance the outcomes of EMT, as it is capable of revealing the thrombus size information, which optimizes the interaction between the stent retriever and the thrombus, while simultaneously reducing the risk of vascular injury that is associated with the prolonged use of the stent retriever.
Keywords: Thrombectomy, Stroke, dual-channels bolus contrast injection (Dc-BCI), thrombus distal end, stent retriever, Reperfusion after ischemia
Received: 10 Oct 2024; Accepted: 09 Jan 2025.
Copyright: © 2025 Jiang, Liu, Zhou, Shu, Dong, Xu and Wan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yi-Lin Liu, Shanghai Changzheng Hospital, Huangpu, Shanghai Municipality, China
Xiang Zhou, Quzhou Hospital of Traditional Chinese Medicine, Quzhou, 324002, China
Qin-Qin Shu, Shanghai Fourth People's Hospital, Shanghai, China
Zheng Xu, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Jie-Qing Wan, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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