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J Neurointerv Surg. 2018 Nov;10(11):1092-1096. doi: 10.1136/neurintsurg-2018-013752. Epub 2018 Mar 19.

Extra-small dual-lumen micro-balloon catheters can improve endovascular embolization: an experimental in vivo and in vitro study.

Author information

1
Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
2
Clinic for Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany.
3
Department of Neuropathology, Heidelberg University Hospital, CCU Neuropathology, DKTK and DKFZ, Heidelberg, Germany.
4
Clinic for Diagnostic and Interventional Radiology, Klinikum Stuttgart, Stuttgart, Germany.

Abstract

BACKGROUND:

The embolization technique can have significant impact on the success of endovascular embolization.

OBJECTIVE:

To evaluate the feasibility, embolization characteristics, and embolization extent with a newly developed extra-small micro-balloon catheter in an in vivo and in an in vitro embolization model in comparison with standard microcatheter embolizations.

MATERIALS AND METHODS:

Twenty-eight embolization procedures were performed in the porcine rete mirabile (RM) and in an in vitro embolization model, using either an extra-small (distal outer diameter 1.6 F) dual-lumen micro-balloon catheter or a standard microcatheter. Precipitating hydrophobic injectable liquid (PHIL) was used as embolic agent. Procedure times, number of injections, required volume of embolic agent, and embolization extent (percentage of embolized RM in postinterventional X-ray scans or number of filled sections of the in vitro model) were assessed. Histopathological analyses were performed.

RESULTS:

Total procedure time was significantly shorter (in vivo: 123 s vs 615 s (medians), P=0.001; in vitro: 180 s vs 496 s (medians), P=0.001), number of reflux events was significantly lower (in vivo: 0 vs 9 (medians), P=0.001; in vitro: 0 vs 3 (medians), P=0.001), and embolization extent was significantly higher (in vivo: 96.9% vs 65.6% (medians), P=0.011; in vitro: 26 vs 18 filled sections (medians); P=0.041) for the micro-balloon catheter groups. There was antegrade movement of the PHIL cast after balloon deflation in one in vitro embolization procedure and spontaneous balloon deflation with subsequent reflux in one in vivo embolization procedure.

CONCLUSION:

Extra-small dual-lumen micro-balloon catheters can improve endovascular embolization in comparison with standard microcatheter embolization.

KEYWORDS:

arteriovenous malformation; balloon; catheter; fistula; liquid embolic material

PMID:
29555871
DOI:
10.1136/neurintsurg-2018-013752
[Indexed for MEDLINE]

Conflict of interest statement

Competing interests: DFV: has received travel support outside this work from MicroVention and Stryker GmbH & Co. KG; HUK: reports grants, personal fees and non-financial support from Siemens, personal fees from Boehringer Ingelheim, personal fees and non-financial support from Bayer, personal fees from GSK, personal fees from Novartis, personal fees from Astra Zeneca, personal fees from Philips, personal fees from Bracco, outside the submitted 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; MAM: has received consulting honoraria, speaker honoraria, and travel support outside this work from Codman, Covidien/Medtronic, MicroVention, Phenox, and Stryker. All other authors have nothing to disclose.

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