Accuracy of intravascular microcatheter pressure measurements: an experimental study.

Abstract

Intravascular pressure measurements are considered useful for the monitoring and assessment of endovascular treatment effects in intracranial vascular malformations. Experimental data on the accuracy of these measurements are limited. A flow phantom with defined intraluminal pressures and pulsatility flow waveforms was used in this study. Microcatheters commercially available for neuroendovascular procedures (length 140-155 cm), with different outer (0.5-0.83 mm) and inner (0.3-0.53 mm) diameters, were introduced into the phantom in the direction of flow. In a static experiment, pressure values from 0 to 75 mmHg were applied, and in the dynamic part of the experiment mean pressure values from 25 to 65 mmHg, with a pulsatile amplitude from 70 to 170 mmHg were employed. In the static experiment, there was a linear relationship between the pressure values obtained through the microcatheters and the local transducer of the flow phantom. The pulsatile experiments showed increased damping of the pressure waveforms with decreasing inner diameter of the microcatheters. However, the mean pressure values remained accurate. This experimental study has shown that mean pressure values can be accurately measured through microcatheters from 0.3-0.5 mm inner diameter and more than 140 cm in length. In vivo pressure measurements during interventional procedures are therefore reproducible and can be used for monitoring of embolization effects in patients.

Accuracy and precision of venous pressure measurements of endovascular microcatheters in the setting of dural venous sinus stenosis

“…The Prowler Select Plus and Marksman 27 have the largest IDs of the five microcatheters and displayed the least amount of damping, regardless of circuit configuration, consistent with previous literature 6. As all microcatheter pressure recordings were lower than HFM recordings, this likely played a significant role in their ability to meet ANSI/AAMI standards.…”

“…Therefore, it is not clear whether pressure readings are accurate to the actual venous pressures or reliable between recordings. Henkes e t al analyzed the accuracy and reliability of pressure recordings from various microcatheters in 1999; however, the microcatheters examined are largely not in use today 6. The reliance on accurate pressure measurements across a DVSS to guide treatment for patients with IIH requires an understanding of the potential measurement errors associated with the microcatheter selected.…”

Venous sinus manometry and intervention using the PrimeWire Prestige pressure guidewire: technique and initial experience

“…Although microcatheter recorded waveforms are dampened by increasing catheter length and decreasing inner diameter, this method accurately evaluates the mean pressure for microcatheters with an inner diameter of 0.3–0.5 mm 7. The microcatheter method has been used successfully in diagnosis and treatment, but repeated insertion of the microcatheter and connection to the monitor is cumbersome and time consuming.…”

Intra-arterial pulse wave analysis during thrombectomy for the assessment of collateral status – A feasibility study

“…Nonetheless, our results show that pressure pulse measurements are feasible and may serve as a foundation for further studies. A further limitation is the fact that we conducted our experiments with only one microcatheter, as mechanical properties such as the rigidity of the catheter may have an impact on our results [18]. Another difficulty was the choice of a suitable high and low pass filter.…”