Introduction The SelectFlex guide catheters (Q’apel Medical, Fremont, CA) are a novel group of 7fr. 072’ distal access guide catheters with a proprietary flexible stent embedded within the distal portion of the catheter that enables shifting on the fly between track and support mode. The dual modes allow for bi-axial access for the breadth of cerebrovascular interventional cases eliminating the need for traditional tri-axial ‘tower of power’ constructs. The simplicity of bi-axial access streamlines the procedure, minimizes cost, and improves efficiency. We present a multicenter early user group experience which shows the SelectFlex catheters to safe and effective in a breadth of cerebrovascular interventions.
Methods A retrospective review of consecutive cases utilizing the SelectFlex guides was performed at 4 institutions from February 2020 - October 2022. IRB approval was granted from each institution.
Results A total of 366 consecutive Selectflex cases were identified: 180 were performed radially, 180 femoral, 4 transvenous. 87% of[RT1] cases were performed bi-axially. Of those, 10 required additional support. 267 cases were performed in the anterior circulation, 43 in the posterior circulation, 51 external and 4 venous. The Selectflex catheter was most commonly placed in the petro-cavernous junction (posterior genu) and V4 segment for intracranial cases. There were 130 aneurysm coilings, 121 flow diverters, 29 WEBs, 37 MMA embos, 4 sinus stents, 17 AVM/dAVF embos, 10 tumor embos, 7 carotid stents, 1 Balloon mounted stent, 1 PTA and 1 thrombectomy. There was 1 flow limiting dissection related to guide catheter access. No other significant catheter related complications occurred. Using MSRP data, cost savings using Selectflex over a tri-axial construct ranged from $50/case to $800/case depending[RT2] on the tri-axial devices used.
Conclusion Use of the Selectflex guide catheter system was found to be safe, efficacious and cost effective across the entire scope of neurointerventional procedures. The use of Select Flex guides can simplify procedures, standardize device usage across program, decrease inventory constraints and reduce cost per procedure.
Disclosures I. Chaudry: 2; C; Q’Apel. 4; C; Q’Apel. R. Turner: 4; C; Q’Apel. A. Turk: 4; C; Q’apel. O. Tanweer: None. J. Burkhardt: 2; C; Q’apel. V. Srinivasan: None. B. Jankowitz: None. M. Salem: None. O. Choudhri: 2; C; Q’apel. R. Hanel: None. G. Cortez: None. V. Benalia: None. J. Vargas: 2; C; Q’apel.
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