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Abdelsalam A, Fountain HB, Ramsay IA, Luther EM, Sowlat MM, Silva MA, Hassan AE, Patel AB, Eatz T, Joseph P, Regenhardt RW, Satti SR, Siddiqui AH, Sanikommu S, Baig AA, Khandelwal P, Spiotta AM, Starke RM. First multicenter study evaluating the utility of the BENCHMARK TM BMX TM 81 large-bore access catheter in neurovascular interventions. Interv Neuroradiol 2024:15910199241262848. [PMID: 38899910 DOI: 10.1177/15910199241262848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION This study is the first multicentric report on the safety, efficacy, and technical performance of utilizing a large bore (0.081″ inner diameter) access catheter in neurovascular interventions. METHODS Data were retrospectively collected from seven sites in the United States for neurovascular procedures via large bore 0.081″ inner diameter access catheter (Benchmark BMX81, Penumbra, Inc.). The primary outcome was technical success, defined as the access catheter reaching its target vessel. Safety outcomes included periprocedural device-related and access site complications. RESULTS There were 90 consecutive patients included. The median age of the patients was 63 years (IQR: 53, 68); 53% were female. The most common interventions were aneurysm embolization (33.3%), carotid stenting (12.2%), and arteriovenous malformation embolization (11.1%). The transradial approach was most used (56.7%), followed by transfemoral (41.1%). Challenging anatomic variations included severe vessel tortuosity (8/90, 8.9%), type 2 aortic arch (7/90, 7.8%), type 3 aortic arch (2/90, 2.2%), bovine arch (2/90, 2.2%), and severe angle (<30°) between the subclavian artery and target vessel (1/90, 1.1%). Technical success was achieved in 98.9% of the cases (89/90), with six cases requiring a switch from radial to femoral (6.7%) and one case from femoral to radial (1.1%). There were no access site complications or complications related to the 0.081″ catheter. Two postprocedural complications occurred (2.2%), unrelated to the access catheter. CONCLUSION The BMX™ 81 large-bore access catheters was safe and effective in both radial and femoral access across a wide range of neurovascular procedures, achieving high technical success without any access site or device-related complications.
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Affiliation(s)
- Ahmed Abdelsalam
- Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL, USA
| | - Hayes B Fountain
- Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL, USA
| | - Ian A Ramsay
- Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL, USA
| | - Evan M Luther
- Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL, USA
| | | | - Michael A Silva
- Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL, USA
| | - Ameer E Hassan
- Department of Neurology, University of Texas Rio Grande Valley School of Medicine, Edinburg, TX, USA
| | - Aman B Patel
- Departments of Neurology and Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tiffany Eatz
- Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL, USA
| | - Pradeep Joseph
- Department of Neurosurgery, Rutgers University, Newark, NJ, USA
| | - Robert W Regenhardt
- Departments of Neurology and Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sudhakar R Satti
- Department Neurointerventional Surgery, Christiana Care Health System, Newark, DE, USA
| | - Adnan H Siddiqui
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Sai Sanikommu
- Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL, USA
| | - Ammad A Baig
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | | | - Alejandro M Spiotta
- Department Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Robert M Starke
- Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL, USA
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Starke RM, Abecassis IJ, Saini V, Matouk CC, Hassan AE, Siddiqui AH, Frei DF. Initial experience of using a large-bore (0.096″ inner diameter) access catheter in neurovascular interventions. Interv Neuroradiol 2024; 30:372-379. [PMID: 36114634 PMCID: PMC11310716 DOI: 10.1177/15910199221127074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/31/2022] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION The purpose of this study was to report our initial experience of using a large-bore (0.096″ inner diameter) access catheter in neurovascular interventions. METHODS Data were retrospectively collected from 5 sites in the US for neurovascular procedures performed using a large-bore access catheter. The effectiveness outcome was technical success, defined as the access catheter's successfully reaching its target vessel without conversion to direct carotid puncture or to a smaller-bore access catheter and successfully completing the intended neurointervention. RESULTS One hundred and thirteen procedures performed in 112 patients were included in this study. The mean age of the patients was 67.5 years (SD 16.2), and about half (49.1%) were female. The most common primary access sites were the femoral (64.6%) or radial (32.7%) artery. Challenging anatomic variations included severe vessel tortuosity (26/81, 32.1%), type II aortic arch (17/88, 19.3%), type III aortic arch (14/88, 15.9%), bovine arch (16/104, 15.4%), severe angle (<30°) between the subclavian and target vessel (11/74, 14.9%), and subclavian loop (7/79, 8.9%). The median access time to branch view was 18 min (IQR 11-28, N = 75). The technical success rate was 94.7%. Two dissections (1.8%) were related to the large-bore access catheter. Access site complications occurred in 2 patients (1.8%). Four additional symptomatic periprocedural complications not related to the large-bore access catheter occurred (7.1%). CONCLUSION For neurovascular interventions, a 0.096″ inner diameter access catheter could be used with both femoral and radial arterial approaches, had a high technical success rate, and had a low rate of periprocedural complications.
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Affiliation(s)
- Robert M Starke
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
| | | | - Vasu Saini
- Department of Neurology, University of Miami, Miami, FL, USA
| | - Charles C Matouk
- Department of Neurosurgery and Department of Radiology & Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Ameer E Hassan
- Department of Neurology and Radiology, University of Texas Rio Grande Valley at Valley Baptist Medical Center, Harlingen, TX, USA
| | - Adnan H Siddiqui
- Department of Neurosurgery, University at Buffalo Neurosurgery, Inc., Buffalo, NY, USA
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Saei HM, Miller SE, Pope HM, Hassan AE. Fubuki XF Long Sheath guide catheter use in neuroendovascular procedures: Institutional experience in 60 cases. Interv Neuroradiol 2024:15910199241245601. [PMID: 38592015 DOI: 10.1177/15910199241245601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Endovascular treatment devices require compatible guide catheters to navigate complex vessels and anatomy. The Fubuki XF Long Sheath guide catheter (Fubuki XF) was developed with a 0.090-inch internal diameter with hydrophilic coating, an atraumatic rounded tip, and enhanced trackability and support with gradual shaft transition zones. METHODS We retrospectively analyzed a prospectively maintained database of neuroendovascular patients treated using Fubuki XF at our center (July 2022─May 2023). Baseline/procedural characteristics were collected. Outcomes of interest included technical success (procedure completion with Fubuki XF without alternative guide catheter use) and peri-procedural complications. RESULTS This study included 60 patients (43.3% [26/60] female; mean age: 69.6 ± 9.7) presenting with stenosis (45.0% [27/60]), unruptured aneurysms (31.7% [19/60]), ruptured aneurysm (1.7% [1/60]), arteriovenous fistula (5.0% [3/60]), arteriovenous malformation (3.3% [2/60]), chronic subdural hematoma (3.3% [2/60]), stroke/emboli (6.7% [4/60]), vasospasm (1.7% [1/60]), or carotid web (5.0% [1/60]). Fubuki XF was used to deliver endovascular treatment devices for stenting (43.3% [26/60]), flow diversion (23.3% [14/60]), embolization (11.7% [7/60]), coiling (10.0% [6/60]), balloon angioplasty (10.0% [6/60]), and mechanical thrombectomy (1.7% [1/60]). The Fubuki XF tip was placed in the internal carotid artery in 38.3% (23/60) of cases. Technical success was achieved in all cases. One V1 non-flow-limiting dissection (not related to Fubuki XF) and one failed closure occurred (1.7% [1/60] each). No iatrogenic strokes or intraprocedural ruptures occurred. CONCLUSION We used Fubuki XF to safely and effectively deliver a variety of compatible neuroendovascular devices. Fubuki XF was stable in all cases and locations, and there were no device-related complications or dissections.
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Affiliation(s)
- Hamzah M Saei
- Department of Vascular Neurology, Rio Grande Regional Hospital, McAllen, TX, USA
| | - Samantha E Miller
- Department of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, USA
| | | | - Ameer E Hassan
- Department of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, USA
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Campos JK, Zarrin DA, Meyer BM, Khan MW, Laghari FJ, Collard de Beaufort JC, Amin G, Beaty NB, Bender MT, Suzuki S, Colby GP, Lin LM, Coon AL. Use of a large-bore 088 intracranial access support catheter for delivery of large intracranial devices: case series with the TracStar LDP in 125 cases. J Neurointerv Surg 2024:jnis-2023-021054. [PMID: 38418227 DOI: 10.1136/jnis-2023-021054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/02/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND The delivery of neuroendovascular devices requires a robust proximal access platform. This demand has previously been met with a 6Fr long sheath (8Fr guide) that is placed in the proximal internal carotid artery (ICA) or vertebral artery segments. We share our experience with the first 0.088 inch 8Fr guide catheter designed for direct intracranial access. METHODS We retrospectively reviewed a prospectively maintained IRB-approved institutional database of the senior authors to identify all cases where the TracStar Large Distal Platform (LDP) was positioned within the intracranial vasculature, defined as within or distal to the petrous ICA, vertebral artery (V3) segments, or transverse sinus. Technical success was defined as safe placement of the TracStar LDP within or distal to the described distal vessel segments with subsequent complication-free device implantation. RESULTS Over the 41-month study period from January 2020 to June 2023, 125 consecutive cases were identified in whom the TracStar LDP was navigated into the intracranial vasculature for triaxial delivery of large devices, 0.027 inch microcatheter and greater, for aneurysm treatment (n=108, 86%), intracranial angioplasty/stenting (n=15, 12%), and venous sinus stenting (n=2, 1.6%). All cases used a direct select catheter technique for initial guide placement (no exchange). Posterior circulation treatments occurred in 14.4% (n=18) of cases. Technical success was achieved in 100% of cases. No vessel dissections occurred in any cases. CONCLUSION The TracStar LDP is an 0.088 inch 8Fr guide catheter that can establish direct intracranial access with an acceptable safety profile. This can be achieved in a wide range of neurointerventional cases with a high rate of technical success.
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Affiliation(s)
- Jessica K Campos
- Department of Neurosurgery, University of California Irvine, Orange, California, USA
| | - David A Zarrin
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Benjamen M Meyer
- College of Medicine Tucson, The University of Arizona, Tucson, Arizona, USA
| | - Muhammad Waqas Khan
- Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA
| | - Fahad J Laghari
- Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA
| | | | - Gizal Amin
- Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA
| | - Narlin B Beaty
- Department of Neurosurgery Tallahassee Memorial Hospital, Tallahassee Memorial Hospital Florida State University, Tallahassee, Florida, USA
| | - Matthew T Bender
- Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA
| | - Shuichi Suzuki
- Department of Neurosurgery, University of California Irvine, Orange, California, USA
| | - Geoffrey P Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Li-Mei Lin
- Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA
| | - Alexander L Coon
- Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA
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