TY - JOUR T1 - Safety of the APOLLO Onyx delivery microcatheter for embolization of brain arteriovenous malformations: results from a prospective post-market study JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg DO - 10.1136/neurintsurg-2020-016830 SP - neurintsurg-2020-016830 AU - Philip M Meyers AU - Johanna T. Fifi AU - Kevin M. Cockroft AU - Timothy R. Miller AU - Curtis A. Given AU - Ali R. Zomorodi AU - Bharathi D. Jagadeesan AU - Maxim Mokin AU - Peter Kan AU - Tom L. Yao AU - Orlando Diaz AU - Daniel Huddle AU - Richard J. Bellon AU - Joshua Seinfeld AU - Adam J Polifka AU - David Fiorella AU - Rohan V. Chitale AU - Peter Kvamme AU - Jay T. Morrow AU - Justin Singer AU - Ajay K. Wakhloo AU - Ajit S. Puri AU - Vivek R. Deshmukh AU - Ricardo A. Hanel AU - L. Fernando Gonzalez AU - Henry H. Woo AU - Mohammad Ali Aziz-Sultan Y1 - 2021/01/31 UR - http://jnis.bmj.com/content/early/2021/01/31/neurintsurg-2020-016830.abstract N2 - Background Catheter retention and difficulty in retrieval have been observed during embolization of brain arteriovenous malformations (bAVMs) with the Onyx liquid embolic system (Onyx). The Apollo Onyx delivery microcatheter (Apollo) is a single lumen catheter designed for controlled delivery of Onyx into the neurovasculature, with a detachable distal tip to aid catheter retrieval. This study evaluates the safety of the Apollo for delivery of Onyx during embolization of bAVMs.Methods This was a prospective, non-randomized, single-arm, multicenter, post-market study of patients with a bAVM who underwent Onyx embolization with the Apollo between May 2015 and February 2018. The primary endpoint was any catheter-related adverse event (AE) at 30 days, such as unintentional tip detachment or malfunction with clinical sequelae, or retained catheter. Procedure-related AEs (untoward medical occurrence, disease, injury, or clinical signs) and serious AEs (life threatening illness or injury, permanent physiological impairment, hospitalization, or requiring intervention) were also recorded.Results A total of 112 patients were enrolled (mean age 44.1±17.6 years, 56.3% men), and 201 Apollo devices were used in 142 embolization procedures. The mean Spetzler–Martin grade was 2.38. The primary endpoint was not observed (0/112, 0%). The catheter tip detached during 83 (58.5%) procedures, of which 2 (2.4%) were unintentional and did not result in clinical sequelae. At 30 days, procedure related AEs occurred in 26 (23.2%) patients, and procedure-related serious AEs in 12 (10.7%). At 12 months, there were 3 (2.7%) mortalities, including 2 (1.8%) neurological deaths, none of which were device-related.Conclusion This study demonstrates the safety of Apollo for Onyx embolization of bAVMs.Clinical trial registration CNCT02378883. ER -