Introduction Increased procedure time during endovascular treatment of cerebral aneurysms is associated with increased anesthesia related complications and radiation exposure. Elimination of the need for intermediate catheters during aneurysm treatment may decrease procedure time and increase cost effectiveness. A novel device -the TracStar Large Distal Platform (LDP) -may offer more distal final positioning when compared to commonly used guide catheters, thus decreasing the need for guide catheter use. We investigate the safety and efficacy of the TracStar LDP when used during endovascular aneurysm treatment.

Methods We perform a multicenter retrospective review of endovascular cerebral aneurysm embolizations during which the TracStar LDP was utilized. Aneurysm location, procedural information, and complications were recorded as detailed in the operative note. Vascular tortuosity was assessed via pre-procedural CTA. Distal-most position achieved with TracStar was determined by review of intraprocedural imaging.

Results A preliminary analysis of 30 cases was performed. Flow diversion was performed in 25 cases (83%), and stent assisted coiling was performed in the remainder. The target aneurysm was located in the ICA in 27 cases (90%), the MCA bifurcation in 2 cases (7%), and the ACA in 1 case (3%). An intermediate catheter was required in 18 cases (60%). TracStar LDP achieved stable access to the Cavernous ICA in 70% of cases. Average procedure time was 67± 33 minutes.There were no procedural complications or new neurologic defects after treatment. TracStar LDP was exchanged for an alternative guide catheter in one case due to catheter kinking, and in two cases due to lack of support.

Conclusion Use of Tracstar LDP during flow-diversion and sent-assisted coiling of cerebral aneurysms is safe and effective. Access to the cavernous segment of the ICA was achieved in the majority of cases, and use of an intermediate catheter was not required in 40% of cases. Final analysis of the the full 60 patient multi-center study will be available for presentation at SNIS Annual 2020.

Disclosures D. Bageac: None. R. De Leacy: None.