In vitroassessment of the trackability of neurovascular intermediate catheters: a comparative analysis

Abstract

The advent of new flexible intermediate catheters facilitated manual aspiration thrombectomy (MAT) for treating neurovascular ischaemic diseases. While these catheters are somewhat flexible, most catheters were not designed specifically for aspiration. Trackability is an important property of catheters facilitating catheter advancement in highly tortuous cerebrovasculature. In this study, a novel in vitro trackability test system has been developed using micro pressure transducers and silicone tubes. The exerted force from the catheter tips were quantitatively evaluated while the catheter passed the curved regions. The trackability of three different types of catheters were compared, i.e. Penumbra 054, Concentric DAC 057 and Reverse Reflex. The exerted forces obtained from the first sensor (Sensor 1) during passing the second curve showed the maximum values through the entire transcatheter procedure. When compared, the exerted forces were least for the Penumbra 054 (0.272 ± 0.012 N), representing highly trackable systems in highly tortuous vessel navigation.

Trackability of distal access catheters: an in vitro quantitative evaluation of navigation strategies

“…The quantitative metric used in this study to evaluate navigability is the force (F) required to track through a vascular phantom 7 8. Since higher forces exerted against the vessel walls may imply more events of vascular injury, lower track forces are considered as an indicator of better trackability.…”

Unfavorable Vascular Anatomy during Endovascular Treatment of Stroke: Challenges and Bailout Strategies

“…Some techniques may be used to overcome cervical vascular tortuosity. [51][52][53] Due to the evolving technology of materials for MT, nowadays is feasible to navigate a large-bore catheter (0.074") in the intracranial circulation. These newer-generation catheters anchor around vascular bends as they pass the proximal curve and it may be possible to use them as support for distal vessel progression.…”

“…Aspiration capability and the ability to deliver other devices such as SRs, angioplasty balloons, and self-expanding or balloon-mounted stents should also be considered during the selection of appropriate catheters. 51 A drawback of distal access-guiding catheters (or intermediate catheters [ICs]) is the lack of proximal support. The most significant reported complication of ICs is asymptomatic vasospasm, which occurs in 3.3% of cases.…”

“…Some techniques may be used to overcome cervical vascular tortuosity [ 51 - 53 ]. Due to the evolving technology of materials for MT, nowadays is feasible to navigate a large-bore catheter (0.074”) in the intracranial circulation.…”

“…The ideal catheter would have trackability that requires the minimum force applied by the operator to progress over the successive curves. Aspiration capability and the ability to deliver other devices such as SRs, angioplasty balloons, and self-expanding or balloon-mounted stents should also be considered during the selection of appropriate catheters [ 51 ].…”