Use of the Outreach Distal Access Catheter for Microcatheter Stabilization during Intracranial Arteriovenous Malformation Embolization

M.J Binning,L.N Hopkins,E.F Hauck,E.I Levy,D Orion,A.H Siddiqui,P Yashar

doi:10.3174/ajnr.a2547

Abstract

The Outreach DAC is an intermediate-sized catheter designed for use with the Merci clot retriever in acute stroke. We investigated its utility as an adjunctive device during AVM pedicle embolization. In the authors' opinion, the DAC provided additional guide-catheter and microcatheter support, improved selective angiographic visualization of AVM angioarchitecture, aided microcatheter removal from its embedded position in the AVM Onyx cast, and enhanced local microcatheter control and safety, compared with embolization with the guide and microcatheter alone.

Highlights

ABBREVIATIONS: AVM ϭ arteriovenous malformation; DAC ϭ Distal Access Catheter; DSA ϭ digital subtraction angiography; n-BCA ϭ n-butyl 2-cyanoacrylate
Routine guide catheter runs obtained during DSA results in opacification of all cerebral vessels in the path of that cervical vertebral or carotid artery. This can result in masking of the AVM angioarchitecture because of overlying cerebral vessels
The DAC provides microcatheter support for accessing these vessels by decreasing the length of microcatheter exposed to the ovalization forces within the tortuosity at the skull base

Summary

TECHNICAL NOTE

SUMMARY: The Outreach DAC is an intermediate-sized catheter designed for use with the Merci clot retriever in acute stroke. We investigated its utility as an adjunctive device during AVM pedicle embolization. In the authors’ opinion, the DAC provided additional guide-catheter and microcatheter support, improved selective angiographic visualization of AVM angioarchitecture, aided microcatheter removal from its embedded position in the AVM Onyx cast, and enhanced local microcatheter control and safety, compared with embolization with the guide and microcatheter alone. ABBREVIATIONS: AVM ϭ arteriovenous malformation; DAC ϭ Distal Access Catheter; DSA ϭ digital subtraction angiography; n-BCA ϭ n-butyl 2-cyanoacrylate

INTERVENTIONAL TECHNICAL NOTE

Discussion

Findings

Conclusions