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E-193 Practical uses of the benchmark™ BMX™ 81 in the road less travelled: radial access for neurovascular intervention
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  1. M Marangoni1,
  2. I Macdonald2,
  3. G PIckett3,
  4. A Weeks3,
  5. C Kim1,
  6. A Rohr1,
  7. W Guest1,
  8. M Heran1,
  9. D Volders2
  1. 1Interventional Neuroradiology, Vancouver General Hospital, Vancouver, BC, Canada
  2. 2Neuroradiology, Dalhousie University, Halifax, NS, Canada
  3. 3Neurosurgery, Dalhousie University, Halifax, NS, Canada

Abstract

Background Radial arterial access has gained interest for neurovascular procedures in recent years. Although there are no randomized control trials for neurointervention procedures using radial access, there is growing literature demonstrating its feasibility and favorable outcomes. Equipment technical improvements, like the recently introduced BENCHMARK™ BMX®81 System, have made radial navigation safer, with improved maneuverability and support for a variety of procedures. We present a multicentre case series highlighting our early institutional experience with this guiding catheter.

Methods Retrospective cohort study: 40 patients underwent neurovascular procedures through a radial approach, using the BENCHMARK™ BMX®81 System, from April 2023-January 2024 in two sites. In 14 cases, it was used as a primary sheath and in 26 cases, it was advanced through a 7 French Glidesheath Slender™ radial sheath. Procedures included endovascular thrombectomy, carotid and brachiocephalic artery stenting, middle meningeal artery (MMA) embolization, flow diverter stenting, vertebral artery sacrifice, aneurysm coiling, and WEB™ device deployment.

Results In our series, the BMX®81 was successful in the navigation of the anatomy to the target location in 95% of cases. In one case, the radial approach proved unsuitable due to challenging arch anatomy, and in another a radial loop required ulnar approach conversion. No radial access or BMX®81 related complications were identified. 86% of cases had satisfactory outcomes and no technical difficulties. The remainder presented technical difficulties, but none of these were considered secondary to the puncture site or support structure.

Conclusions The BENCHMARK™ BMX®81 System is a recently developed guiding catheter which can be used for radial access, providing support and navigability for a variety of neurovascular interventions. Early multicenter experience highlights the ease of use and versatility as an alternative to transfemoral access.

Abstract E-193 Figure 1

A: BMX 81 guide catheter navigating tortuous neurovasculature from a right radial approach. A tortuous origin of the right common carotid artery from the brachiocephalic artery (white arrow) as well as a tortuous course of the cervical right internal carotid artery (black arrow) was navigated by the guide catheter. B: The aspiration catheter was able to navigate to the occlusion in the right MCA (arrowhead)

Disclosures M. Marangoni: None. I. Macdonald: None. G. PIckett: None. A. Weeks: None. C. Kim: None. A. Rohr: None. W. Guest: None. M. Heran: None. D. Volders: 2; C; Penumbra.

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