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Abstract
Background Endovascular device effectiveness and safe use rely on closely simulating real-world scenarios during preclinical testing. This study mainly focused on endoscopic evaluation of radial access catheter failure mechanisms tested on human cadaveric models.
Methods A human cadaveric model was created by catheterizing the ascending and descending aorta in a cadaver model consisting of the head, neck, bilateral arms, and torso. An endoscopic camera was inserted through the ascending aorta to evaluate radial access catheter performances. Blood-mimicking fluid was circulated in the cadaver model using an external pump. Bilateral radial access was obtained using 7F slender sheaths. All catheters were tested by a senior neurointerventionist, and during the procedures, all movements of catheters were recorded endoscopically. All recorded videos are evaluated by experienced neurointerventionists to find out possible failure mechanisms of radial access catheters.
Results We identified four possible failure mechanisms associated with current-market radial access catheters. These failure mechanisms were simultaneously demonstrated through endoscopic and fluoroscopic imaging. They include insufficient torque transmission, catheter whipping due to torque build-up, scratching atheroma plaques during catheter advancement, catheters getting stuck during advancement by the septum between the brachiocephalic trunk and the left common carotid, and catheters becoming lodged on the edge of the inner vascular layer. All failure mechanisms were documented through endoscopic and fluoroscopic recordings.
Conclusions The development and optimization of radial access catheters are necessary. Visualizing possible failure mechanisms will contribute to a better understanding of these failure mechanisms and enable the development of more effective catheters.
Disclosures Y. Senol: 6; C; Microvention. M. Asghariahmadabad: 6; C; Microvention. N. Krishnan: None. A. Orscelik: None. L. Savastano: 4; C; Endovascular Horizons. 5; C; Endovascular Engineering, VerAvanti.