The Versatile Distal Access Catheter: The Cleveland Clinic Experience

Abstract

The DAC is useful for gaining access to the cerebral vasculature, especially in patients with significant tortuosity or when re-access of distal vasculature is required multiple times.

Comparison of Stent-Retriever Devices versus the Merci Retriever for Endovascular Treatment of Acute Stroke

“…The usefulness of the DAC was reported in a recently published article. 37 However, we used the DAC in both groups, almost equally often. Fourth, the availability of all necessary imaging tools and the presence of a diagnostic neurointerventionalist for 24 hours improved our patient selection based on an interdisciplinary decision.…”

Endovascular Methods for the Treatment of Intracranial Cerebral Aneurysms

“…New guide catheters that are more flexible, such as the Neuron (Penumbra, Alameda, CA), Navien (eV3, Irvine, CA), or distal accesses catheters (DAC) (Stryker, Fremont, CA) can be introduced further into the intracranial circulation, and can be routinely placed in the cavernous internal carotid artery or the distal vertebral artery. [108][109][110][111] This placement allows more stability in advancing devices into the intracranial circulation. This increased stability has been a major innovation in the endovascular treatment of aneurysms over the last 3 years.…”

General Considerations for Neurointerventional Procedures

“…It has been used in a number of off-label settings, including aneurysm and AVM embolization and treatment of acute ischemic stroke and intracranial stenosis. 85,86 Other catheters can be used besides the DAC in a triaxial arrangement. Be sure the microcatheter is long enough to extend out of the DAC by a meaningful distance.…”