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Abstracts
Ischemic
2.3. Treatment
P017 Intracranial dotter angioplasty using tenzing 7 for symptomatic atherosclerotic stenosis: initial multicenter experience
Free
  1. Fabio Settecase1,2,
  2. Rajkamal Khangura3,
  3. Omar Kass-Hout4,
  4. Warren Kim1,2,
  5. Matthew Alexander3,
  6. Ashish Gajjar1,
  7. Jaehyun Kim1,
  8. Mubashir Pervez5,
  9. Joey English1,2,
  10. Guilherme Dabus5
  1. 1California Pacific Medical Center, San Francisco, USA
  2. 2Mills Peninsula Medical Center, Burlingame, USA
  3. 3Sutter Sacramento Medical Center, Sacramento, USA
  4. 4University of North Carolina Rex, Raleigh, USA
  5. 5Baptist Hospital, Miami, USA

Abstract

Introduction Traditional endovascular treatment of intracranial atherosclerotic disease (ICAD) includes balloon angioplasty and stenting. Catheter-mediated (‘Dotter’) angioplasty has been previously described for extracranial arteries. The Tenzing 7 (Route 92 Medical, San Mateo, CA) shelf-reducing delivery catheter has an atraumatic tapered distal tip that progressively enlarges to a 0.062 inch (1.6 mm) outer diameter (figure 1).

Abstract P017 Figure 1
Abstract P017 Figure 1

Aim of Study We report our initial multicenter experience in treating symptomatic ICAD steno-occlusive lesions using Dotter angioplasty/Tenzing-plasty.

Methods After local IRB approvals, we retrospectively reviewed consecutive patients undergoing endovascular treatment for symptomatic ICAD with off-label Tenzing-plasty, as a first approach at our stroke centers from 2021-2024. Subsequent adjunctive balloon angioplasty and/or stenting were performed at operator discretion.

Results Twenty-eight consecutive underwent Tenzing-plasty, either as part of an emergent large vessel occlusion mechanical thrombectomy procedure, or if medical management of ICAD had previously failed. Median age was 63±12 years and 13 were female (46%). Stenosis location was: 12 M1, 7 M2, 2 ICA, 6 vertebral V4 segment, 1 basilar. The average pre-treatment ICAD stenosis was 95±7%, including 13/28(46%) with complete occlusion on initial angiogram. In 28/28(100%), Tenzing-plasty resulted in improvement in arterial caliber after median 1 pass (IQR 1-1), with average stenosis improving to 64±15%. Subsequent balloon angioplasty was performed in 5/28(18%). Stenting was performed in 12/28(43%) cases using a variety of self-expading or balloon-mounted stents. There were no instances of arterial perforation or symptomatic intracranial hemorrhage.

Conclusion Tenzing-plasty is a feasible and safe alternative technique for improving luminal caliber and flow restoration for symptomatic ICAD lesions. Further study is warranted.

Disclosure of Interest yes Consultant: Route 92 Medical, Stryker Research grants: Stryker, Microvention Equity interest: Route 92 Medical.

https://doi.org/10.1136/jnis-2024-ESMINT.54

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