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Sakai C, Sakai N, Takayanagi A, Imamura H, Ohta T, Koyanagi M, Goto M, Fukumitsu R, Sunohara T, Fukui N, Matsumoto S, Akiyama T, Takano Y, Haruyama H, Go K, Kajiura S, Shigeyasu M, Asakura K, Horii R, Naramoto Y, Nishii R, Yamamoto Y, Teranishi K, Kawade S, Imahori T, Kaneko N, Tateshima S. First-in-human trial of Stabilizer device in neuroendovascular therapy. Heliyon 2023; 9:e14360. [PMID: 36950603 PMCID: PMC10025140 DOI: 10.1016/j.heliyon.2023.e14360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 02/09/2023] [Accepted: 03/01/2023] [Indexed: 03/13/2023] Open
Abstract
Objectives Flow diverter or stent implantation to intracranial target lesion requires large inner diameter microcatheter navigation. The exchange method using stiff long wire is often necessary if it is difficult to navigate over the regular guidewire. However, this method has an intrinsic risk of vessel damage and may cause severe complications. We investigated the safety and efficacy of a new device, the Stabilizer device for navigation in a first-in-human clinical trial under the Certified Review Board agreement. Materials and methods The Stabilizer is a 320 cm length exchange wire with a stent for anchoring and is compatible with a 0.0165" microcatheter. The trial design is a prospective single-arm open-label registry. Inclusion criteria are elective flow diverter treatment or stent-assisted coiling, expected to be difficult to navigate a microcatheter with a regular micro guidewire, and obtained documented consent. The primary endpoint of the study was a hemorrhagic complication. Results Five patients were enrolled in this trial. The median age is 52 years, ranges from 41 to 70, and all patients were female. Three aneurysms were located on the internal carotid artery, one on the vertebral artery, and one on the basilar artery. Basilar artery aneurysm was treated by stent-assisted coiling and others were treated by flow diverter deployment. All cases successfully navigate microcatheter for the treatment by the trial method using Stabilizer device without any adverse event. Conclusions The results from this first-in-human consecutive five cases show the safety of the Stabilizer device in neuro-endovascular therapy for navigation of devices to the intracranial target lesion.
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Affiliation(s)
- Chiaki Sakai
- Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Japan
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
- Corresponding author. Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital. 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047 Japan
| | - Nobuyuki Sakai
- Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Japan
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ariel Takayanagi
- Division of Interventional Neuroradiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA
- Department of Neurological Surgery, Riverside University Health System, Moreno Valley, CA, USA
| | - Hirotoshi Imamura
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tsuyoshi Ohta
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masaomi Koyanagi
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masanori Goto
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ryu Fukumitsu
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tadashi Sunohara
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuyuki Fukui
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shirabe Matsumoto
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tomoaki Akiyama
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yuki Takano
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hironori Haruyama
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Koichi Go
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shinji Kajiura
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masashi Shigeyasu
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kento Asakura
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ryo Horii
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yuji Naramoto
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Rikuo Nishii
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yasuhiro Yamamoto
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kunimasa Teranishi
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Satohiro Kawade
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Taichiro Imahori
- Division of Interventional Neuroradiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA
| | - Naoki Kaneko
- Division of Interventional Neuroradiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA
| | - Satoshi Tateshima
- Division of Interventional Neuroradiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA
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