Bradley A Gross1,2, William J Ares1,2, Cynthia L Kenmuir1,3, Ashutosh P Jadhav1,3, Tudor G Jovin1,3, Brian T Jankowitz1,2. 1. Stroke Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 2. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 3. Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Abstract
INTRODUCTION: Distal access catheters are an infrequent focus of technical notes in neurointervention. The 5-French SOFIA's unique design allows for compatibility with 6-French guide catheters, while its supple construction allows for remarkably distal access for a catheter with a 0.055-inch inner diameter. METHODS: The authors reviewed a prospectively maintained endovascular database for cases utilizing the 5-French SOFIA from February 2017 through November 2017. Case type, SOFIA location, microcatheter used, and catheter-related complications were noted. RESULTS: Over the evaluated period, the 5-French SOFIA was utilized in 33 cases, including 13 aneurysm treatments, 10 arteriovenous shunt embolizations, 5 stroke thrombectomies, and 5 other cases. Of 5 flow diversion cases, 1 was for a symptomatic cavernous internal carotid artery aneurysm necessitating transradial access, another for a ruptured A3 aneurysm, and another for a middle cerebral artery (M2) aneurysm; 2 were more proximal aneurysms. Thrombectomies were for M2 (n = 3) or A2 (n = 2) occlusions. In all cases, the 5-French SOFIA reached its anticipated distal target without complication or the need to utilize a smaller/alternative catheter. Of these 33 cases, there were 10 cases of distal SOFIA target locations: 6 M2/M3, 3 anterior cerebral arteries (ACA), and 1 posterior cerebral artery (PCA). M2/M3 and PCA catheterization was achieved over 2.1-Fr microcatheters; ACA catheterization employed a 2.9-Fr microcatheter for pipeline embolization and a deployed stentriever in the setting of two thrombectomies. CONCLUSION: The 5-French SOFIA can be safely utilized for distal, superselective catheterization in the context of complex neurointervention, including aneurysm and arteriovenous shunt embolization and distal thrombectomy.
INTRODUCTION: Distal access catheters are an infrequent focus of technical notes in neurointervention. The 5-French SOFIA's unique design allows for compatibility with 6-French guide catheters, while its supple construction allows for remarkably distal access for a catheter with a 0.055-inch inner diameter. METHODS: The authors reviewed a prospectively maintained endovascular database for cases utilizing the 5-French SOFIA from February 2017 through November 2017. Case type, SOFIA location, microcatheter used, and catheter-related complications were noted. RESULTS: Over the evaluated period, the 5-French SOFIA was utilized in 33 cases, including 13 aneurysm treatments, 10 arteriovenous shunt embolizations, 5 stroke thrombectomies, and 5 other cases. Of 5 flow diversion cases, 1 was for a symptomatic cavernous internal carotid artery aneurysm necessitating transradial access, another for a ruptured A3 aneurysm, and another for a middle cerebral artery (M2) aneurysm; 2 were more proximal aneurysms. Thrombectomies were for M2 (n = 3) or A2 (n = 2) occlusions. In all cases, the 5-French SOFIA reached its anticipated distal target without complication or the need to utilize a smaller/alternative catheter. Of these 33 cases, there were 10 cases of distal SOFIA target locations: 6 M2/M3, 3 anterior cerebral arteries (ACA), and 1 posterior cerebral artery (PCA). M2/M3 and PCA catheterization was achieved over 2.1-Fr microcatheters; ACA catheterization employed a 2.9-Fr microcatheter for pipeline embolization and a deployed stentriever in the setting of two thrombectomies. CONCLUSION: The 5-French SOFIA can be safely utilized for distal, superselective catheterization in the context of complex neurointervention, including aneurysm and arteriovenous shunt embolization and distal thrombectomy.
Authors: M A Möhlenbruch; C Kabbasch; A Kowoll; E Broussalis; M Sonnberger; M Müller; M Wiesmann; J Trenkler; M Killer-Oberpfalzer; W Weber; A Mpotsaris; M Bendszus; S Stampfl Journal: J Neurointerv Surg Date: 2016-12-20 Impact factor: 5.836
Authors: Jeremy J Heit; Johnny Hy Wong; Adrienne M Mofaff; Nicholas A Telischak; Robert L Dodd; Michael P Marks; Huy M Do Journal: J Neurointerv Surg Date: 2017-08-02 Impact factor: 5.836