Abstract 343: Novel Carrier‐plasty to Post‐process Flow Diverting Stents During Aneurysm Embolization with Carrier Delivery Catheter

• Published in: Stroke: vascular and interventional neurology 2024-11, Vol.4 (S1)
• Main Authors: Scarpiello, S, Snyder, T, Haimi, J, Vyas, S, Zacharatos, H, Jankowitz, B
• Format: Article
• Language: English
• Subjects: Aneurysms; Catheters; Embolization; Stents
• ISSN: 2694-5746; 2694-5746
• DOI: 10.1161/SVIN.04.suppl_1.343

IntroductionDelivery catheters can facilitate quick and efficient access of tortuous vessels to aid in acute interventions such as thrombectomy. The Carrier Delivery Catheter (The Balt Group, Montmorency, France) has a hydrophilic coating, an atraumatic tapered tip, a PTFE liner through the length of the catheter, and can accommodate a wire. With these added benefits, the Carrier Delivery Catheter may have novel applications such as post‐processing flow diverting stents that fail to maximally open during aneurysm embolizations.MethodsAt our university based medical center, we used a Carrier Delivery Catheter to post‐process a Pipeline Embolization Device (PED) flow diverting stent (Medtronic, Minneapolis, Minnesota) during the elective embolization of a superior hypophyseal artery (SHA) aneurysm.ResultsAn unruptured, irregularly shaped, SHA aneurysm with a neck measuring 5.4 mm and dome measuring 7.1 mm underwent treatment with a 4.5 mm x 16 mm PED deployed through a Phenom 27 across the aneurysm neck, extending from just proximal to the anterior choroidal artery origin to the mid‐cavernous ICA. A Carrier Delivery Catheter Large (OD 1.75 mm) had already been opened to facilitate advancement of a 6F Benchmark to the mid cavernous segment, thereby avoiding the need of a mid‐sized distal access catheter. After deployment, the distal end of the PED remained constrained, only achieving a diameter of 1.3 mm in a 3.4 mm vessel. To maximize wall apposition, the Carrier was passed through the deployed pipeline stent over a wire. Follow up runs confirmed optimal wall apposition of the stent throughout its course, achieving a final distal diameter of 3.4 mm, with improved aneurysm stasis and minimal residual filling.ConclusionIn our limited experience, the Carrier Delivery Catheter was able to post‐process a PED through tortuous anatomy. While additional studies are needed to support our findings, this novel technique of post‐processing flow diverting stents with a Carrier Delivery Catheter appeared safe and effective, with the additional benefit of using a utilitarian device that had already been opened.