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Abstract
Introduction There are no resources that directly compare the properties of similar devices used in neuro endovascular procedures. Device selection for an endovascular procedure can reduce or increase the risk of a complication during the procedure. Intracranial support catheters are typically advanced through a guide catheter over a microcatheter into the intracranial circulation. A feared complication from intracranial support catheters is arterial dissection. It is hypothesized that catheter tip stiffness is a factor in the risk of tearing the arterial wall while navigating through a bend in an artery.
Methods Testing apparatus was created by gluing wooden pegs into a wooden board to hold a catheter in a straight position lengthwise along the board. A small hole was cut in a rubber band which was suspended between the last two wooden pegs. The small rubber band hole was used to secure the catheter tip during bending. Two pulleys were clamped to the board to suspend a line attached to lead weights on either end. The catheter tip was secured to the line by a piece of thread (see Figure 1). The catheter was tested over paper with distance and angle measurements. The pulleys and fishing line were set to 45 degrees making it possible to measure force perpendicular to the catheter when bent to a 45 degree angle. The catheters were tested with 4 cm extending through the fixation point with the point of deflection force at 2 cm from the fixation point (a 2 cm bend 2 cm from the tip). The catheters were tested again with 3 cm extending through the fixation point and the point of deflection at 1 cm from the fixation point (a 1 cm bend 2 cm from the tip).
Results The Sofia distal access catheter has the least amount of force required to bend the tip 45 degrees at a 1 cm bend and 2 cm bend, see figures. The 044 DAC, 053 Neuron, 058 Navien, and 5MAX distal delivery catheter had similar forces required to deflect 45 degrees. The DAC required the most force in the group of the intermediate sized catheters to bend 45 degrees at both 1 cm and 2 cm distances between the deflection point and fixation point. The 070 Neuron was the largest and required the most force to deflect the catheter tip, overall. It required almost twice the force to deflect 45 degrees over a 2 cm bend.
Disclosures K. Shea: None. B. Jagadeesan: None.