Article Text
Abstract
Introduction The SelectFlex guide catheters (Q’Apel Medical, Fremont, CA) are novel, dual-mode next generation 7fr. 072’ distal access guide catheters with a proprietary flexible stent embedden within the distal wall of the catheter. This enables physician-controlled modulation of the catheter between track and support modes.
Aim of Study We present a multicenter experience which investigates the safety and efficacy of these catheters in the treatment of intracranial aneurysms that traditionally require tri-axial support, namely intrasaccular and endoluminal flow diversion.
Methods A retrospective review of consecutive cases utilizing the SelectFlex guides was performed at 4 institutions from February 2020 – October 2022 under IRB approval.
Results A total of 366 consecutive Selectflex cases were identified. Of those, 150 flow diversion cases were performed (121 endoluminal, 29 intrasaccular); 95 via radial access and 55 via femoral access. 78% of cases were performed bi-axially. The Selectflex catheter was most commonly placed in the posterior genu of the cavernous internal carotid. There was no incidence of vascular injury or dissection. Three adverse events identified were identified: an intraprocedural rupture during WEB placement, epistaxis two weeks post op, and metabolic encephalopathy unrelated to the procedure. Utilizing MSRP data, using Selectflex in a bi-axial approach versus a tri-axial construct can save up to $800/case.
Conclusion Use of the Selectflex catheters was found to be safe, efficacious and cost effective for intra-saccular and endoluminal flow diversion. We found that using this catheter can simplify procedures, standardize device usage across program, decrease inventory constraints, and reduce cost per procedure.
Disclosure of Interest This manuscript was developed, researched, analyzed, and written independent of financial or industry support or involvement.
The following potential COI are Q’Apel Medical
Siemens Healthineers
Medtronic
Integra Lifesciences
Cerenovus
Stryker
Penumbra
Microvention
Balt