Intermediate catheter placement distal to the cerebral aneurysm during flow diversion embolization with the Surpass device.
PURPOSE
We present the preliminary angiographic and clinical results of the combined utilization of an AXS Catalyst 5 (Cat5) distal access catheter and a Surpass flow diverter (SFD) for the endovascular treatment of intracranial aneurysms.


MATERIALS AND METHODS
Interventional neuroradiology case records were evaluated retrospectively to identify patients treated with an SFD in combination with Cat5. Demographic data, technical success, location of the catheter tip, aneurysm occlusion rate, and procedure-related morbidity and mortality were noted.


RESULTS
The analysis yielded 24 patients with 25 aneurysms with a mean age of 52.3±19.7 years. The mean aneurysm diameter was 15.7±8.8 mm. Twenty-one were anterior circulation (seven supraclinoid, one middle cerebral, one anterior choroidal and 12 petrocavernous) and four were posterior circulation (three basilar tip, one posterior inferior cerebellar) aneurysms. Only two of these aneurysms were re-treatments for recurrences. For SFD deployment, the distal tip of Cat5 was placed intradurally and at, or distal to, M1 segment in 88% and 48% of patients, respectively. Aneurysms were bypassed with Cat5 in 80% of the procedures. In one patient, flow diversion was abandoned totally due to arterial tortuosity. With the exclusion of this patient, the technical success rate was 91.7%. There was no permanent procedure-related morbidity or mortality. Of the 22 aneurysms treated successfully with the Surpass device, 20 had imaging follow-up at 6.3±3.8 months and 95% were totally occluded.


CONCLUSION
The Cat5 catheter, which was manufactured for the navigation of large-bore stent-like devices, is a useful adjunct to the Surpass device and allowed us to deploy the device safely.
['Topcuoglu|Osman Melih|OM|', 'Arat|Anil|A|', 'Peker|Ahmet|A|http://orcid.org/0000-0002-5998-1304', 'Sarikaya|Basar|B|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D057785:Catheters D002533:Cerebral Angiography D004621:Embolization, Therapeutic D057510:Endovascular Procedures D005260:Female D006801:Humans D002532:Intracranial Aneurysm D008297:Male D008875:Middle Aged D012189:Retrospective Studies D000069322:Self Expandable Metallic Stents D016896:Treatment Outcome D055815:Young Adult
catheter aneurysm artery