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Case series
Headway Duo microcatheter for cerebral arteriovenous malformation embolization with n-BCA
  1. Jeremy J Heit1,
  2. Abigail G S Faisal1,
  3. Nicholas A Telischak1,
  4. Omar Choudhri2,
  5. Huy M Do1
  1. 1Department of Radiology, Interventional Neuroradiology Division, Stanford University Hospital, Stanford, California, USA
  2. 2Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to Dr Jeremy J Heit, Department of Radiology, Neuroimaging and Neurointervention, Stanford University Hospital, 300 Pasteur Drive, S0047, Stanford, CA 94305, USA; jheit{at}stanford.edu

Abstract

Background Cerebral arteriovenous malformations (AVMs) are uncommon vascular lesions, and hemorrhage secondary to AVM rupture results in significant morbidity and mortality. AVMs may be treated by endovascular embolization, and technical advances in microcatheter design are likely to improve the success and safety of endovascular embolization of cerebral AVMs.

Objective To describe our early experience with the Headway Duo microcatheter for embolization of cerebral AVMs with n-butyl-cyanoacrylate (n-BCA).

Methods Consecutive patients treated by endovascular embolization of a cerebral AVM with n-BCA delivered intra-arterially through the Headway Duo microcatheter (167 cm length) were identified. Patient demographic information, procedural details, and patient outcome were determined from electronic medical records.

Results Ten consecutive patients undergoing cerebral AVM embolization using n-BCA injected through the Headway Duo microcatheter were identified. Presenting symptoms included headache, hemorrhage, seizures, and weakness. Spetzler Martin grades ranged from 1 to 5, and AVMs were located in the basal ganglia (2 patients), parietal lobe (4 patients), frontal lobe (1 patient), temporal lobe (1 patient), an entire hemisphere (1 patient), and posterior fossa (1 patient). 50 arterial pedicles were embolized, and all procedures were technically successful. There was one post-procedural hemorrhage that was well tolerated by the patient, and no other complications occurred. Additional AVM treatment was performed by surgery and radiation therapy.

Conclusions The Headway Duo microcatheter is safe and effective for embolization of cerebral AVMs using n-BCA. The trackability and high burst pressure of the Headway Duo make it an important and useful tool for the neurointerventionalist during cerebral AVM embolization.

  • Arteriovenous Malformation
  • Liquid Embolic Material
  • Catheter

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Footnotes

  • Contributors All authors made substantial contributions to the conception and design of the study, acquisition of data, or analysis and interpretation of data.

  • Competing interests HMD received consulting funds from MicroVention.

  • Ethics approval Ethics approval was obtained from Stanford Medical Center IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Published and unpublished data may be shared for additional publications pending the authors’ agreement to a research collaboration when appropriate.

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