First clinical multicenter experience with the new Scepter Mini microballoon catheter.
Adult
Angiography
/ methods
Balloon Occlusion
/ instrumentation
Catheters
Central Nervous System Vascular Malformations
/ diagnostic imaging
Embolization, Therapeutic
/ instrumentation
Female
Humans
Intracranial Arteriovenous Malformations
/ diagnostic imaging
Male
Middle Aged
Polyvinyls
/ administration & dosage
Retrospective Studies
Treatment Outcome
arteriovenous malformation
balloon
catheter
liquid embolic material
vascular malformation
Journal
Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
03
04
2020
revised:
20
05
2020
accepted:
25
05
2020
pubmed:
18
6
2020
medline:
27
4
2021
entrez:
18
6
2020
Statut:
ppublish
Résumé
Balloon-assisted techniques can improve the endovascular treatment of cerebrospinal vascular malformations. The aim of this study was to report the first clinical multicenter experience with the new Scepter Mini dual-lumen microballoon catheter. Patients with cerebral or spinal vascular malformations treated with the Scepter Mini at seven European neurovascular centers were retrospectively reviewed. Clinical data, angiographic features of the vascular malformations, procedural parameters including the type of application, navigability, technical failures, complications and embolization success were assessed. The usage of 34 Scepter Mini microballoon catheters in 20 patients was analyzed. Most treated malformations (80.0%) were cerebral arteriovenous malformations. Four different applications were reported: embolization via Scepter Mini (n=23, 67.6%), balloon-occlusion with simultaneous embolization via a second microcatheter (n=3, 8.8%), diagnostic angiography with simultaneous balloon-inflation for flow arrest (n=4, 11.8%), and navigation support (n=4, 11.8%). The mean diameter of the blood vessels in which the Scepter Mini was inflated was 1.9±0.5 mm. The navigability of the Scepter Mini was rated as 'easy' or 'very easy' in 88.2% of cases. Complete occlusion of the malformation was achieved in 60.9% of cases. Technical failures occurred in 4/23 embolization procedures, and all were related to insufficient stability of the balloon within the vessel. No complications related to the Scepter Mini were observed, while unrelated complications occurred in three patients (15.0%). The Scepter Mini is a promising new device for balloon-assisted embolization of cerebrospinal vascular malformations via small feeders. Beyond embolization, the Scepter Mini can also be used for other applications, such as superselective flow arrest and navigation support.
Sections du résumé
BACKGROUND
BACKGROUND
Balloon-assisted techniques can improve the endovascular treatment of cerebrospinal vascular malformations. The aim of this study was to report the first clinical multicenter experience with the new Scepter Mini dual-lumen microballoon catheter.
METHODS
METHODS
Patients with cerebral or spinal vascular malformations treated with the Scepter Mini at seven European neurovascular centers were retrospectively reviewed. Clinical data, angiographic features of the vascular malformations, procedural parameters including the type of application, navigability, technical failures, complications and embolization success were assessed.
RESULTS
RESULTS
The usage of 34 Scepter Mini microballoon catheters in 20 patients was analyzed. Most treated malformations (80.0%) were cerebral arteriovenous malformations. Four different applications were reported: embolization via Scepter Mini (n=23, 67.6%), balloon-occlusion with simultaneous embolization via a second microcatheter (n=3, 8.8%), diagnostic angiography with simultaneous balloon-inflation for flow arrest (n=4, 11.8%), and navigation support (n=4, 11.8%). The mean diameter of the blood vessels in which the Scepter Mini was inflated was 1.9±0.5 mm. The navigability of the Scepter Mini was rated as 'easy' or 'very easy' in 88.2% of cases. Complete occlusion of the malformation was achieved in 60.9% of cases. Technical failures occurred in 4/23 embolization procedures, and all were related to insufficient stability of the balloon within the vessel. No complications related to the Scepter Mini were observed, while unrelated complications occurred in three patients (15.0%).
CONCLUSIONS
CONCLUSIONS
The Scepter Mini is a promising new device for balloon-assisted embolization of cerebrospinal vascular malformations via small feeders. Beyond embolization, the Scepter Mini can also be used for other applications, such as superselective flow arrest and navigation support.
Identifiants
pubmed: 32546639
pii: neurintsurg-2020-016115
doi: 10.1136/neurintsurg-2020-016115
doi:
Substances chimiques
Polyvinyls
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
261-266Informations de copyright
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: DFV has received travel support outside this work from MicroVention and Stryker GmbH & Co. KG. IS is a consultant for Medtronic and Microvention outside of this work. SC is a shareholder of Vesalio and a consultant for Medtronic, and MicroVention outside of this work and is a stockholder in ELUM and NDI. NK is a consultant for MicroVention and Medtronic (consultant and proctorship agreement) outside of this work and received payments for lectures from MicroVention outside of this work. NAS is a consultant for Medtronic, Balt Extrusion, Microvention, Stock/Stock Options: Medina. MNP reports travel grants and speaker’s honoraria from Stryker Neurovascular, Phenox, Penumbra, Acandis, and Siemens outside of this work. MB reports board membership: DSMB Vascular Dynamics; consultancy: Roche, Guerbet, Codman; grants/grants pending: DFG, Hopp Foundation, Novartis, Siemens, Guerbet, Stryker, Covidien; payment for lectures (including service on speakers bureaus): Novartis, Roche, Guerbet, Teva, Bayer, Codman; MM has received consulting honoraria, speaker honoraria, and travel support outside this work from Codman, Covidien/Medtronic, MicroVention, Phenox, and Stryker.