Early institutional experience using the TracStar Large Distal Platform in endovascular flow diversion

Bageac, Devin; Gershon, Blake S; Shigematsu, Tomoyoshi; Majidi, Shahram; Leacy, Reade De

doi:10.1177/19714009211041520

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…9 Likewise, Bageac et al reported their experience in 42 patients with using a new 0.088 ′′ ID AC, via a femoral approach, for flow diversion; they reported a dissection rate of 2.3% (1/44 interventions). 11 Thus, the BMX96 has a complication rate that is similar to those reported for other neurointerventional ACs with a similar but smaller ID. Although some other larger ACs (i.e.…”

Section: Advantages Of the Bmx96supporting

confidence: 68%

“…10 Bageac et al reported use of another 0.088 ′′ ID AC, via a femoral approach, in 44 flow diversion cases; the success rate was 97.7% and the combined rate of type II or III aortic arch was 54%. 11 Thus, technical success rates may be a function of both underlying tortuosity and approach. Two successful conversions in our series were initially attempted radially with the LB-AC without success, but then the target vessel was achieved via a femoral approach, suggesting that the combination of vessel tortuosity (subclavian kink plus type II aortic arch, or type III aortic arch) and radial access was not ideal for those cases.…”

Section: Technical Success and Tortuositymentioning

confidence: 99%

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Initial experience of using a large-bore (0.096″ inner diameter) access catheter in neurovascular interventions

et al. 2022

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Introduction The purpose of this study was to report our initial experience of using a large-bore (0.096″ inner diameter) access catheter in neurovascular interventions. Methods Data were retrospectively collected from 5 sites in the US for neurovascular procedures performed using a large-bore access catheter. The effectiveness outcome was technical success, defined as the access catheter's successfully reaching its target vessel without conversion to direct carotid puncture or to a smaller-bore access catheter and successfully completing the intended neurointervention. Results One hundred and thirteen procedures performed in 112 patients were included in this study. The mean age of the patients was 67.5 years (SD 16.2), and about half (49.1%) were female. The most common primary access sites were the femoral (64.6%) or radial (32.7%) artery. Challenging anatomic variations included severe vessel tortuosity (26/81, 32.1%), type II aortic arch (17/88, 19.3%), type III aortic arch (14/88, 15.9%), bovine arch (16/104, 15.4%), severe angle (<30°) between the subclavian and target vessel (11/74, 14.9%), and subclavian loop (7/79, 8.9%). The median access time to branch view was 18 min (IQR 11-28, N = 75). The technical success rate was 94.7%. Two dissections (1.8%) were related to the large-bore access catheter. Access site complications occurred in 2 patients (1.8%). Four additional symptomatic periprocedural complications not related to the large-bore access catheter occurred (7.1%). Conclusion For neurovascular interventions, a 0.096″ inner diameter access catheter could be used with both femoral and radial arterial approaches, had a high technical success rate, and had a low rate of periprocedural complications.

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Section: Advantages Of the Bmx96supporting

confidence: 68%

Section: Technical Success and Tortuositymentioning

confidence: 99%

Initial experience of using a large-bore (0.096″ inner diameter) access catheter in neurovascular interventions

et al. 2022

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“…These results suggest the TracStar LDP may provide additional benefits in other neurointerventional procedures such as aneurysm embolization, where superior distal access and proximal support is also desired – as demonstrated by Bageac et al in the use of the Tracstar LDP for endovascular placement of flow diverting stents. 11…”

Section: Discussionmentioning

confidence: 99%

Utility of the novel guide catheter in mechanical thrombectomy for emergent large vessel occlusion stroke

et al. 2022

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Background A number of large bore guide catheters are currently available for use in neuroendovascular surgery. This study represents a multi-institutional retrospective series of patients undergoing mechanical thrombectomy with the use of a TracStar Large Distal Platform (LDP) guide catheter and assessed its performance in vivo in 107 patients. Objective To review a multi-institutional initial experience with the TracStar LDP guide catheter during mechanical thrombectomy for emergent large vessel occlusion (ELVO). Methods A retrospective review was performed at two level one stroke centres to include all patients who underwent mechanical thrombectomy and had the TracStar LDP guide catheter used during the intervention. Results The TracStar LDP guide catheter was successfully used in 107 mechanical thrombectomies. In anterior circulation ELVO, the guide catheter advanced into the cavernous segment of the internal carotid artery in 62.6% (62/99) of cases. In posterior circulation cases, the guide catheter advanced to the basilar artery in 87.5% (7/8) of cases. A thrombolysis in cerebral infarction 2b or greater reperfusion was obtained in 90.7% (97/107). No complications occurred related to the TracStar LDP guide catheter. Three complications occurred with aspiration catheters including a small dissection that did not require further intervention and fracturing of the AXS Catalyst 6 catheter tip in two cases. No thromboembolic events occurred. Conclusions The TracStar LDP large bore guide catheter is safe and effective at navigating the tortuous vascular anatomy often encountered during mechanical thrombectomy for stroke. The flexible distal and stiffer proximal components provide a good combination of navigability and support for use in neuroendovascular interventions.

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“…The delivery of neuroendovascular devices requires a catheter access platform which features robust proximal and distal support, and trackability through tortuous vasculature. [1][2][3][4] These requirements have been commonly met by the use of a triaxial system consisting of a guide catheter, intermediate catheter, and a microcatheter system. 5 6 An 0.088 inch (8Fr) guide catheter is often used in these set-ups to provide proximal support while traversing the aortic arch and large proximal vessels, with smaller diameter intermediate catheters used to provide distal support closer to the site of intervention.…”

Section: Introductionmentioning

confidence: 99%

“…The TracStar Large Distal Platform (LDP) (Imperative Care, Campbell, California, USA) is the first ever supportive 0.088 inch guide catheter with a hyperflexible tip designed to track to the intracranial vasculature. 3 This catheter is 105 cm in length and has a unique angled tip, and proprietary durometer transitions facilitate navigation into the cavernous internal carotid artery (ICA) which offer improved stability across major vessels and may provide improved stability for the delivery of large diameter neurointerventional devices. Furthermore, intracranial positioning of an 0.088 inch guide may provide a similar level of distal support to triaxial systems and enable a simplified biaxial system to be used in some cases.…”

Section: Introductionmentioning

confidence: 99%

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

Campos,

Zarrin,

Meyer

et al. 2024

J NeuroIntervent Surg

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BackgroundThe 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.MethodsWe 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.ResultsOver 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.ConclusionThe 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.

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Early institutional experience using the TracStar Large Distal Platform in endovascular flow diversion

Cited by 4 publications

References 16 publications

Initial experience of using a large-bore (0.096″ inner diameter) access catheter in neurovascular interventions

Initial experience of using a large-bore (0.096″ inner diameter) access catheter in neurovascular interventions

Utility of the novel guide catheter in mechanical thrombectomy for emergent large vessel occlusion stroke

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

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