Tapan Mehta1,2, Ameer Hassan3, Kamran Masood1, Wondwossen Tekle3, Andrew Grande1, Ramachandra Tummala1, Bharathi D Jagadeesan1. 1. Department of Neurology, Neurosurgery and Radiology, University of Minnesota, Minneapolis, MN, USA. 2. Ayer Neuroscience Institute, Hartford Healthcare, Hartford, CT, USA. 3. Department of Neuroscience, Valley Baptist Medical Center/University of Texas Rio Grande Valley, Harlingen, TX, USA.
Abstract
BACKGROUND: The use of compliant dual lumen balloon microcatheters (CDLB) for the endovascular treatment of vascular malformations, wide neck aneurysms, and intracranial angioplasty (for vasospasm) is well documented. Navigation of 4 mm or larger CDLB within tortuous and small distal intracranial vessels can be challenging. Recently, the lower profile Scepter Mini balloon microcatheter (SMB) has been approved for use, with potential for improved intracranial navigation. OBJECTIVE: Discuss operative experience of Scepter Mini (Microvention, Aliso Viejo, CA). METHODS: We describe our initial experience with the SMB in a series of nine patients. RESULTS: The balloon microcatheter was used for delivery of liquid embolic in six patients (Case 1, 2, 6-9), adjunct support for delivery or positioning of the Woven Endobridge (WEB) device in two (Case 3,4), and gentle post-deployment repositioning of a WEB device in the last one (Case 5). We were able to successfully navigate the SMB over a 0.008 "micro wire to the target lesion in all the patients. We experienced initial difficulty with injecting liquid embolic in Case 2. We postulate that the SMB was in a tortuous segment of a dural vessel in this patient, and that it kinked on inflation with occlusion of the liquid embolic delivery lumen; this was overcome with slightly proximal repositioning and reinflation of the SMB. CONCLUSION: Our initial experience shows that the SMB has potential to be useful in endovascular neurosurgical procedures requiring balloon assistance within smaller diameter blood vessels.
BACKGROUND: The use of compliant dual lumen balloon microcatheters (CDLB) for the endovascular treatment of vascular malformations, wide neck aneurysms, and intracranial angioplasty (for vasospasm) is well documented. Navigation of 4 mm or larger CDLB within tortuous and small distal intracranial vessels can be challenging. Recently, the lower profile Scepter Mini balloon microcatheter (SMB) has been approved for use, with potential for improved intracranial navigation. OBJECTIVE: Discuss operative experience of Scepter Mini (Microvention, Aliso Viejo, CA). METHODS: We describe our initial experience with the SMB in a series of nine patients. RESULTS: The balloon microcatheter was used for delivery of liquid embolic in six patients (Case 1, 2, 6-9), adjunct support for delivery or positioning of the Woven Endobridge (WEB) device in two (Case 3,4), and gentle post-deployment repositioning of a WEB device in the last one (Case 5). We were able to successfully navigate the SMB over a 0.008 "micro wire to the target lesion in all the patients. We experienced initial difficulty with injecting liquid embolic in Case 2. We postulate that the SMB was in a tortuous segment of a dural vessel in this patient, and that it kinked on inflation with occlusion of the liquid embolic delivery lumen; this was overcome with slightly proximal repositioning and reinflation of the SMB. CONCLUSION: Our initial experience shows that the SMB has potential to be useful in endovascular neurosurgical procedures requiring balloon assistance within smaller diameter blood vessels.
Authors: Alejandro M Spiotta; Robert F James; Stephen R Lowe; Jan Vargas; Aquilla S Turk; M Imran Chaudry; Tarun Bhalla; Rashid M Janjua; John J Delaney; Stacey Quintero-Wolfe; Raymond D Turner Journal: J Neurointerv Surg Date: 2014-08-12 Impact factor: 5.836
Authors: Bharathi D Jagadeesan; Mikayel Grigoryan; Ameer E Hassan; Andrew W Grande; Ramachandra P Tummala Journal: Neurosurgery Date: 2013-12 Impact factor: 4.654
Authors: Dominik F Vollherbst; René Chapot; Marta Wallocha; Isil Saatci; Saruhan Cekirge; Aymeric Rouchaud; Charbel Mounayer; Naci Kocer; Osman Kizilkilic; Nader A Sourour; Eimad Shotar; Marios N Psychogios; Alex Brehm; Martin Bendszus; Markus A Möhlenbruch Journal: J Neurointerv Surg Date: 2020-06-16 Impact factor: 5.836