Article Text
Abstract
Introduction The Vecta46 intermediate catheter, recently approved by the FDA, introduces a mini-triaxial access system designed to accommodate 0.058’ guides, 0.027’ microcatheters, and allows angiographic injections through a 0.070’ guide catheter. Noteworthy features include a soft, atraumatic tip for distal reach, an 11 cm distal flex zone for improved trackability, a 25 cm distal hydrophilic coating for smooth navigation, a full-length PTFE liner for seamless therapy delivery, and a Nitinol cross coil proximal segment for support and pushability.
Methods We conducted a retrospective review of patients who underwent endovascular procedures utilizing the Vecta46 intermediate catheter.
Results The most prevalent comorbidity was hypertension (48.4%), followed by hyperlipidemia (38.7%). 51.6% were on antiplatelets and 12.9% on anticoagulants. Aneurysm treatments constituted the majority (54.8%) of cases, followed by Onyx embolization for dAVF (12.9%), MMA embolization for cSDH with nBCA (12.9%), thrombectomies for stroke (9.7%), and Onyx embolization for AVMs (9.7%). Flow diversion comprised the most common aneurysm treatment (58.8%; figure 1), followed by Contour (17.6%), stent-assisted coiling (11.8%), simple coiling (5.9%), and Onyx embolization (5.9%). Most procedures were transradial (74.2%) with the access site on the right side (87.1%), and verapamil was used in 71.0%. The mean number of vessels selected (excluding access site) was 3.2±1.5, procedure duration 97.5±74.9 mins, fluoroscopy time 47.1±36.0 mins, contrast dose 82.9±31.9 mL, and reference air kerma 2385.0±1455.2 mGy. One transfemoral conversion was necessary. Vecta46 was successfully navigated to the target vessel in 27 (87.1%) cases, with alternative catheters used in the remaining 4. Intraprocedural complications included a possible embolization of a nontarget vessel, a thromboembolic complication treated with thrombectomy, and a non-flow limiting focal dissection that was angioplastied. No hemorrhagic complications, vessel irregularities, vasospasm, or dissection occurred in the Vecta46 catheter region. No immediate post-procedural complications were noted apart from forearm edema at the procedure’s onset and a small hematoma at the puncture site.
Conclusion The new Vecta46 intermediate catheter can be effectively and safely utilized across a variety of endovascular procedures.
Disclosures G. Sioutas: None. A. Napole: None. O. Shekhtman: None. S. Kandregula: None. J. Burkhardt: None. V. Srinivasan: None.