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Title: The Steerable Microcatheter: A New Device for Selective Catheterisation

Abstract

The steerable microcatheter (SwiftNINJA, Sumitomo Bakelite, Tokyo, Japan), which has a remote-controlled flexible tip manipulated using a dial in the handgrip, was recently developed and delivered to the market. This device enables the user to change the angle of the microcatheter tip manually, and potentially makes selective catheterisation easier. We evaluated its unique characteristics and utility in selective catheterisation and coil embolization. This article describes: (1) the advantages of this device in catheterisations involving acute angle branches, and (2) a new technique of compact coil packing with the use of intentional folding by the bendable tip of the catheter.

Authors:
 [1];  [2]; ; ; ;  [1]
  1. Hokkaido University Hospital, Department of Diagnostic and Interventional Radiology (Japan)
  2. Sapporo Yamanoue Hospital, Department of Radiology (Japan)
Publication Date:
OSTI Identifier:
22645179
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 6; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; EQUIPMENT; JAPAN; PACKINGS; STOWING; THERAPY; VASCULAR DISEASES

Citation Formats

Soyama, Takeshi, Yoshida, Daisuke, Sakuhara, Yusuke, E-mail: yusaku@med.hokudai.ac.jp, Morita, Ryo, Abo, Daisuke, and Kudo, Kohsuke. The Steerable Microcatheter: A New Device for Selective Catheterisation. United States: N. p., 2017. Web. doi:10.1007/S00270-017-1579-3.
Soyama, Takeshi, Yoshida, Daisuke, Sakuhara, Yusuke, E-mail: yusaku@med.hokudai.ac.jp, Morita, Ryo, Abo, Daisuke, & Kudo, Kohsuke. The Steerable Microcatheter: A New Device for Selective Catheterisation. United States. doi:10.1007/S00270-017-1579-3.
Soyama, Takeshi, Yoshida, Daisuke, Sakuhara, Yusuke, E-mail: yusaku@med.hokudai.ac.jp, Morita, Ryo, Abo, Daisuke, and Kudo, Kohsuke. Thu . "The Steerable Microcatheter: A New Device for Selective Catheterisation". United States. doi:10.1007/S00270-017-1579-3.
@article{osti_22645179,
title = {The Steerable Microcatheter: A New Device for Selective Catheterisation},
author = {Soyama, Takeshi and Yoshida, Daisuke and Sakuhara, Yusuke, E-mail: yusaku@med.hokudai.ac.jp and Morita, Ryo and Abo, Daisuke and Kudo, Kohsuke},
abstractNote = {The steerable microcatheter (SwiftNINJA, Sumitomo Bakelite, Tokyo, Japan), which has a remote-controlled flexible tip manipulated using a dial in the handgrip, was recently developed and delivered to the market. This device enables the user to change the angle of the microcatheter tip manually, and potentially makes selective catheterisation easier. We evaluated its unique characteristics and utility in selective catheterisation and coil embolization. This article describes: (1) the advantages of this device in catheterisations involving acute angle branches, and (2) a new technique of compact coil packing with the use of intentional folding by the bendable tip of the catheter.},
doi = {10.1007/S00270-017-1579-3},
journal = {Cardiovascular and Interventional Radiology},
number = 6,
volume = 40,
place = {United States},
year = {Thu Jun 15 00:00:00 EDT 2017},
month = {Thu Jun 15 00:00:00 EDT 2017}
}
  • Purpose. To evaluate the efficacy of embolotherapy using microcatheters in patients with hemorrhage from various locations. Methods. Among 29 patients there were 13 with severe epistaxis, 7 with gastrointestinal bleeding, 4 with hemorrhage in the kidney, 4 with bleeding in pelvic organs and 1 with bleeding in the shoulder region. In all cases, a Tracker-18 or Tracker-10 microcatheter was advanced coaxially through a 4.1 Fr guiding catheter in order to reach the bleeding site as distally as possible. Polyvinyl alcohol microparticles and/or platinum microcoils were used as embolic material. Results. The bleeding was stopped in 90% (26 of 29) ofmore » cases. In 66% of cases the treatment was curative, in 7% preoperative, and in 17% palliative. There were 3 clinical failures. Conclusion. Microcatheter embolization is an effective and safe means of managing different kinds of hemorrhage of various causes from a variety of sites.« less
  • Purpose: To assess the efficacy and safety of microcatheter embolization in the treatment of intractable idiopathic epistaxis. Methods: Thirty-seven patients underwent microcatheter embolization in 1991-1998. We evaluated retrospectively the technical and clinical outcome, the number of complications, the duration of embolization in each case, and the number of blood transfusions needed. All embolizations were done with biplane digital subtraction angiography (DSA) equipment. The procedure was carried out under local anesthesia using transfemoral catheterization, except in one case where the translumbar route was used. Tracker 18 or 10 microcatheters were advanced as far as possible to the distal branches of themore » sphenopalatine artery. Polyvinyl alcohol (PVA) particles were used for embolization in most cases, while platinum coils or a combination of these two materials were occasionally used. The primary outcome was always assessed immediately by angiography. Follow-up data were obtained from patient records, by interviewing patients on the telephone or by postal questionnaires when necessary. The mean follow-up time was 21 months. Results: The embolization was technically successful in all 37 cases. A curative outcome was achieved in 33 cases (89%). The mean duration of the procedure was 110 min. Four patients (8%) had mild transient complications, but no severe or persistent complications were encountered. Twenty-three patients needed a blood transfusion. Slight rebleeding occurred in three patients during the follow-up; all responded to conservative treatment. One patient suffered two episodes of rebleeding within 2 months after primary embolization. Re-embolizations successfully stopped the bleeding. Conclusion: Embolization is the primary invasive modality for treating intractable idiopathic epistaxis. It proved both safe and effective over a relatively long follow-up.« less
  • Early attempts of using embolization for lower gastrointestinal hemorrhage were fraught with complications, most notably ischemic colitis or bowel infarction. Embolotherapy was eventually abandoned in favor of catheter-directed vasoconstriction (i.e., vasopressin infusion). This latter therapy is time and labor intensive. With the advent of microcatheter technology, superselective embolization emerged and is rapidly becoming the endovascular therapy of choice for patients with severe lower gastrointestinal hemorrhage refractory to medical management. Numerous studies on the subject have consistently reported high clinical success with low ischemic complications. This article will review the current status of co-axial microcatheter embolization with an emphasis on themore » technical aspects of the procedure.« less
  • We report the combined use of an occlusion balloon catheter and a microcatheter for transcatheter arterial embolization (TAE) of hepatocellular carcinoma (HCC) fed by the unselectable right inferior phrenic artery (IPA). In one case, HCC was fed by the reconstructed right IPA via a small branch arising from the proximate portion of the celiac artery. In another, the tumor was fed by the right IPA that had been previously embolized with coils. TAE was successfully performed through a microcatheter placed in the celiac artery immediately proximal to the occluding balloon catheter of the celiac trunk and coil embolization of themore » left gastric artery.« less
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