Case Studies

8F EmerAX / TracLine Large Bore Intermediate Catheter Assists SWIM Thrombectomy

Surgeon's profile

Cao Yuezhou
MD, Deputy Chief Physician, Interventional Department, Jiangsu Provincial People’s Hospital.

Jiangsu Provincial Medical Association Stroke Branch Neurointerventional Group, Jiangsu Provincial Medical Association Interventional Physician Branch Neurointerventional Group. Specialized in neurologic intervention, especially in acute and chronic ischemic cerebrovascular disease interventional therapy. Published more than 10 papers as the first author, 7 of which are included in SCI.

Case information

Patient: Female, 71 years old
Chief Complaint: Sudden onset of left-sided limb weakness accompanied by slurred speech for 3.5 hours.
Past Medical History: Hypertension and atrial fibrillation.
Physical Examination on Admission: Specialist examination on admission: Drowsy, unclear speech. Muscle strength of the left limbs is at grade 0. Decreased sensation in the left limbs, presence of physiological reflexes, no pathological signs on the left side (-). Preoperative NHISS score: 21 points.

Imaging Examination

Preoperative CT indicated an occlusion in M1 segment of right MCA
Preoperative CT perfusion imaging indicated a core infarct volume of 10 ml and a Tmax>6s volume of 105 ml, showing a significant mismatch

Surgical Procedure

Main interventional device selection during the procedure:

  • Traxcess 14
  • Rebar 18
  • 8F EmerAX / TracLine Intermediate Catheter 088*100
  • 6F EmerAX / TracLine Intermediate Catheter 065*127
  • Solitaire AB 4*20

Treatment Process

Cervical segment of right ICA is relatively curved
Occlusion of M1 segment of right MCA

8F TracLine Intermediate Catheter has a 15cm soft distal tip, which easily bypasses the curvature of right ICA and passes smoothly through petrous segment

Solitaire AB 4mm*20mm post-release angiography

Under tension, 8F EmerAX / TracLine Intermediate Catheter continues to advance to C3, providing strong support to help the 6F EmerAX /TracLine easily reach M1 segment.

SWIM technique becomes simpler with just one pass.

Final anteroposterior and lateral angiography shows grade 3 recanalization of vessel

Postoperative scan after 24 hours

Preoperative Observation

  1. Patient is alert and able to engage in simple communications after the surgery.
     
  2. Muscle strength:
    1. Left upper limb: grade 2
    2. Lower limb: grade 3.

Observer Comments

1. Occlusion of the MCA in this patient is a routine embolectomy in clinical practice. Using SWIM technique for such cases often gets good recanalization.
2. The core of SWIM technology is that the intermediate catheter should travel high to be near the thrombus to play an important role in aspiration protection. This is often challenging for entry level practitioners.​​
3. The 8F EmerAX / TracLine 2-in-1 intermediate catheter is a natural replacement for the traditional guiding or long sheath as it can easily reach C3 or higher positions. With this strong support, the 6F EmerAX / TracLine catheter easily reaches the MCA, achieving a one-pass recanalization using the SWIM technology.

Observer Profile

Liu Sheng, MD

  • Post-doctoral, professor, graduate tutor, deputy director of the intervention department of Jiangsu Provincial People’s Hospital, chief physician, Jiangsu Province ‘key medical talents’, ‘six peak talents’.
  • Vice Chairman of Chinese Society of Radiology Interventional Group Neurointerventional Special Committee
  • Jiangsu Provincial Medical Association Interventional Branch
  • Jiangsu Provincial Stroke Association Neurointerventional Committee
  • Jiangsu Provincial Association of Physicians Neurointerventional Special Committee,
  • Nanjing Medical Association Interventional Branch Director.
  • Presided over 5 national and provincial level projects, published more than 30 SCI papers as the first or corresponding author, and served as a review expert for AJNR, CVIR, DIR and other journals.

About Hemo

Hemo Biotechnology Co., Ltd. (referred to as “Hemo”) officially commenced operations in 2017. Hemo’s global headquarters is located in Singapore, with research and development centers in both Singapore and China. It collaborates with long-term partners in the United States to focus on new product design and keep abreast of cutting-edge global technologies. 
Hemo is dedicated to integrating high-quality global research and development, production, clinical, and academic resources to provide innovative vascular and neurointerventional products for patients and medical professionals. It aims to offer comprehensive intervention solutions for cerebrovascular diseases, including ischemic stroke, hemorrhagic stroke, and intracranial vascular stenosis.