Balloon remodeling for aneurysm coil embolization with the coaxial lumen Scepter C balloon catheter: initial experience at a high volume center

Spiotta, Alejandro M; Miranpuri, Amrendra; Hawk, Harris; Chaudry, M Imran; Turk, Aquilla S; Turner, Raymond D

doi:10.1136/neurintsurg-2012-010552

Cited by 27 publications

(20 citation statements)

References 8 publications

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“…The ability of the microcatheter to accommodate a 0.014-inch microwire is also advantageous as this allows for easier microcatheterization of potentially challenging, spastic vessels. We also agree with other authors that the larger microwire and distal “nose” provide additional subjective stability during balloon inflation [11,17]. We typically utilize 100% contrast and have not had issues with prolonged inflation or deflation times.…”

Section: Discussionsupporting

confidence: 59%

“…Its utility as a balloon adjunct for aneurysm coiling [11], arteriovenous malformation embolization [12,13,14], and tumor embolization [15,16] has been described. Its dual coaxial lumen design accommodates a 0.014-inch microwire, allowing for more facile microcatheter delivery, enhanced stability/reduced “watermelon seeding,” and the ability to infuse a vasodilator superselectively prior to angioplasty.…”

Section: Introductionmentioning

confidence: 99%

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Septoplasty: Scepter Balloon Angioplasty for Vasospasm after Aneurysmal Subarachnoid Hemorrhage

et al. 2017

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Introduction: Balloon angioplasty can be a requisite approach for the treatment of symptomatic and/or severe vasospasm. Dual-lumen microcatheter balloons have multiple potential advantages for this indication including accommodating a 0.014-inch wire and the potential to deliver superselective vasodilators directly via the microcatheter prior to angioplasty. Methods: The authors reviewed a 3-year institutional experience with the Scepter XC balloon (Microvention, Tustin, CA, USA) in the treatment of postaneurysmal subarachnoid hemorrhage vasospasm, focusing on treatment methods, angiographic, and clinical results. Results: Sixty-four vessels were treated in 18 patients. Fifteen cases were performed under intravenous (i.v.) conscious sedation (83%). The mean pretreatment stenosis was 59% (range 40-80), and the mean post-treatment stenosis was 12% (range 0-40). Five vessels in 3 patients were subsequently retreated via angioplasty for recurrent vasospasm (8%). There were no complications related to the passage of the balloon microcatheter or inflation of the balloon such as dissection or vessel rupture. Of 14 patients with delayed cerebral ischemia, 7 had complete symptomatic resolution after treatment, and 3 had significant symptomatic improvement. Four patients did not improve after treatment though 3 already had confirmed infarcts on imaging prior to angiography. Conclusion: The Scepter XC is a safe and effective balloon microcatheter for angioplasty of cerebral vasospasm after subarachnoid hemorrhage, allowing for superselective delivery of a vasodilator. Its ease of deliverability and visibility often allows for the performance of the procedure under i.v. conscious sedation.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Septoplasty: Scepter Balloon Angioplasty for Vasospasm after Aneurysmal Subarachnoid Hemorrhage

et al. 2017

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“…[1][2][3][4] Advancements in technology, such as trackable balloons, self expanding stents, and flow diverters, allow endovascular treatment of most cerebral aneurysms. [5][6][7][8][9][10][11] However, aneurysm residuals or recanalization remains a challenge. To this end, continued effort must be made to advance coil technology in order to improve long term occlusion rates.…”

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confidence: 99%

Periprocedural safety of aneurysm embolization with the Medina Coil System: the early human experience

Turk

Maia

Ferreira

et al. 2015

J NeuroIntervent Surg

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IntroductionIntracranial saccular aneurysms, if untreated, carry a high risk of morbidity and mortality from intracranial bleeding. Embolization coils are the most common treatment. We describe the periprocedural safety and performance of the initial human experience with the next generation Medina Coil System.MethodsThe Medina Coil System is a layered three-dimensional coil made from a radiopaque, shape set core wire, and shape memory alloy outer coil filaments. Nine aneurysms in five patients were selected for treatment with the Medina Coil System.ResultsNine aneurysms in five patients, ranging from 5 to 17 mm in size in various locations, were treated with the Medina Coil System. No procedural or periprocedural complications were encountered. Procedure times, number of coils used to treat the aneurysm, and use of adjunctive devices were much less than anticipated if conventional coil technology had been used.ConclusionsThe Medina Coil System is a next generation coil that combines all of the familiar and expected procedural safety and technique concepts associated with conventional coils. We found improved circumferential aneurysm filling, which may lead to improved long term outcomes, with fewer devices and faster operating times.

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“…First case report on the Scepter C balloon catheter usage documented that all types of 0.014-inch guidewire compatibility was very helpful (12). A recent case series mentioned that the Scepter C balloon catheter was only navigated in one of the 52 aneurysms at various locations, and only one adverse event (1.9%) was documented with attributions to balloon use (aneurysm perforation); thus, suggesting the safety and convenience of Scepter balloon catheter (13). An additional advantage is that the Scepter balloon catheter has a 5 mm-length soft distal catheter tip that permits steam shaping.…”

Section: Discussionmentioning

confidence: 99%

Initial Experience with the New Double-lumen Scepter Balloon Catheter for Treatment of Wide-necked Aneurysms

et al. 2013

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ObjectiveA new double-lumen balloon catheter was being developed for the treatment of cerebral aneurysms. The purpose of this study is to report our initial experience of a double-lumen balloon catheter for the treatment of wide-necked aneurysms.Materials and MethodsSeventeen patients (mean age, 63 years; range, 45-80 years) with wide-necked, with or without a branch-incorporated aneurysms, (10 ruptured and 9 unruptured) were treated with balloon-assisted coil embolization using a double-lumen balloon catheter (Scepter C™ or Scepter XC™) for 7 months after being introduced to our country. Locations of the aneurysms were posterior communicating artery (n = 7), anterior communicating artery or A2 (n = 7), middle cerebral artery (MCA) bifurcation (n = 3), basilar artery tip (n = 1) and anterior choroidal artery (n = 1). The initial clinical and angiographic outcomes were retrospectively evaluated.ResultsCoil embolization was successfully completed in all 19 aneurysms, resulting in complete occlusions (n = 18) or residual neck (n = 1). In one procedure, a thrombus formation was detected at the neck portion of the ruptured MCA bifurcation aneurysm near to the end of the procedure. It was completely resolved with an intra-arterial infusion of Glycoprotein IIb/IIIa inhibitor (Tirofiban, 1.0 mg) without any clinical sequela. There were no treatment-related events in the remaining 18 aneurysms. At discharge, functional neurological state improved in 11 patients (10 patients with ruptured aneurysm and 1 with unruptured aneurysm presenting with mass symptoms) and 6 patients with unruptured aneurysms had no newly developed symptoms.ConclusionIn this preliminary case series, the newly developed double-lumen Scepter balloon appears to be a safe and convenient device for coil embolization of wide-necked aneurysms.

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Balloon remodeling for aneurysm coil embolization with the coaxial lumen Scepter C balloon catheter: initial experience at a high volume center

Cited by 27 publications

References 8 publications

Septoplasty: Scepter Balloon Angioplasty for Vasospasm after Aneurysmal Subarachnoid Hemorrhage

Septoplasty: Scepter Balloon Angioplasty for Vasospasm after Aneurysmal Subarachnoid Hemorrhage

Periprocedural safety of aneurysm embolization with the Medina Coil System: the early human experience

Initial Experience with the New Double-lumen Scepter Balloon Catheter for Treatment of Wide-necked Aneurysms

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