학술논문
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.
Document Type
Academic Journal
Author
Campos JK; Department of Neurosurgery, University of California Irvine, Orange, California, USA camposjk@uci.edu.; Zarrin DA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.; Meyer BM; College of Medicine Tucson, The University of Arizona, Tucson, Arizona, USA.; Khan MW; Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA.; Laghari FJ; Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA.; Collard de Beaufort JC; College of Arts and Science, Syracuse University, Syracuse, New York, USA.; Amin G; Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA.; Beaty NB; Department of Neurosurgery Tallahassee Memorial Hospital, Tallahassee Memorial Hospital Florida State University, Tallahassee, Florida, USA.; Bender MT; Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA.; Suzuki S; Department of Neurosurgery, University of California Irvine, Orange, California, USA.; Colby GP; Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA.; Lin LM; Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA.; Coon AL; Carondelet Neurological Institute, Carondelet Saint Joseph's Hospital, Tucson, Arizona, USA.
Source
Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101517079 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1759-8486 (Electronic) Linking ISSN: 17598478 NLM ISO Abbreviation: J Neurointerv Surg Subsets: MEDLINE
Subject
Language
English
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.
Competing Interests: Competing interests: ALC is a consultant for Medtronic Neurovascular, MicroVention-Terumo, Stryker Neurovascular, Cerenovus, Rapid Medical, Avail MedSystems, Imperative Care, Deinde, InNeuroCo, Q’apel; a proctor for MicroVention-Termo, Stryker Neurovascular, and Medtronic Neurovascular. L-ML is a proctor for Medtronic Neurovascular, Stryker Neurovascular, MicroVention-Terumo; and a consultant for Medtronic Neurovascular, Stryker Neurovascular, MicroVention-Terumo, Rapid Medical, and Balt. GPC is a consultant for Medtronic Neurovascular, MicroVention-Terumo, Rapid Medical, Cerenovus, and Stryker Neurovascular. MTB is a proctor for Stryker Neurovascular. NBB is a proctor for Medtronic Neurovascular, Stryker Neurovascular, and CMO of NeuroMedica. All other authors have no conflict of interest. No author received financial support in conjunction with the generation of this submission.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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.
Competing Interests: Competing interests: ALC is a consultant for Medtronic Neurovascular, MicroVention-Terumo, Stryker Neurovascular, Cerenovus, Rapid Medical, Avail MedSystems, Imperative Care, Deinde, InNeuroCo, Q’apel; a proctor for MicroVention-Termo, Stryker Neurovascular, and Medtronic Neurovascular. L-ML is a proctor for Medtronic Neurovascular, Stryker Neurovascular, MicroVention-Terumo; and a consultant for Medtronic Neurovascular, Stryker Neurovascular, MicroVention-Terumo, Rapid Medical, and Balt. GPC is a consultant for Medtronic Neurovascular, MicroVention-Terumo, Rapid Medical, Cerenovus, and Stryker Neurovascular. MTB is a proctor for Stryker Neurovascular. NBB is a proctor for Medtronic Neurovascular, Stryker Neurovascular, and CMO of NeuroMedica. All other authors have no conflict of interest. No author received financial support in conjunction with the generation of this submission.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)