ACCESS: ACtive Catheterization for EndovaScular TreatmentS-A First-in-Human, Single-Center, Nonrandomized, Open Clinical Study of the G60 Active Device for Endovascular Neurointerventions.
[en] The catheterization of supra-aortic vessels during neuroendovascular interventions may be challenging in the setting of complex aortic arch anatomy. Evaluation of a new mechatronic controllable directional device in conjunction with different sheath and guide catheters to ease the cannulation of the supra-aortic vessels was conducted in the setting of a first-in-human clinical study. The evaluation assessment included access to the aortic arch, the technical success of the device in terms of time to target vessel, target vessel catheterization, adverse events, and clinical outcome. Ten subjects were enrolled at 1 site for treatment. Successful access, target vessel catheterization, and correct positioning of the catheter into the target vessel with the G60 device were achieved for all 10 procedures (7 from femoral access, 3 from radial access). One procedural complication, unrelated to the G60 device, was recorded during the investigation. The G60 is a polyvalent active device that facilitates guide catheter navigation in neuroendovascular interventions.
Disciplines :
Neurology
Author, co-author :
Escalard, Simon ; From the Department of Interventional Neuroradiology (S.E., J.-P.D., H.R., S.S., F.D., W.B., A.A.-R., M.M., M.P.), Rothschild Foundation Hospital, Paris, France simon.escalard@gmail.com
Al-Raaisi, Amira ; From the Department of Interventional Neuroradiology (S.E., J.-P.D., H.R., S.S., F.D., W.B., A.A.-R., M.M., M.P.), Rothschild Foundation Hospital, Paris, France
Désilles, Jean-Philippe ; From the Department of Interventional Neuroradiology (S.E., J.-P.D., H.R., S.S., F.D., W.B., A.A.-R., M.M., M.P.), Rothschild Foundation Hospital, Paris, France
Redjem, Hocine ; From the Department of Interventional Neuroradiology (S.E., J.-P.D., H.R., S.S., F.D., W.B., A.A.-R., M.M., M.P.), Rothschild Foundation Hospital, Paris, France
Smajda, Stanislas ; From the Department of Interventional Neuroradiology (S.E., J.-P.D., H.R., S.S., F.D., W.B., A.A.-R., M.M., M.P.), Rothschild Foundation Hospital, Paris, France
Lahlouh, Mounir; CREsTIC (M.L.), Université de Reims, Reims, France
Delvoye, François ; Université de Liège - ULiège > Département des sciences cliniques ; From the Department of Interventional Neuroradiology (S.E., J.-P.D., H.R., S.S., F.D., W.B., A.A.-R., M.M., M.P.), Rothschild Foundation Hospital, Paris, France
Boisseau, William ; From the Department of Interventional Neuroradiology (S.E., J.-P.D., H.R., S.S., F.D., W.B., A.A.-R., M.M., M.P.), Rothschild Foundation Hospital, Paris, France
Mazighi, Mikaël ; From the Department of Interventional Neuroradiology (S.E., J.-P.D., H.R., S.S., F.D., W.B., A.A.-R., M.M., M.P.), Rothschild Foundation Hospital, Paris, France
Piotin, Michel ; From the Department of Interventional Neuroradiology (S.E., J.-P.D., H.R., S.S., F.D., W.B., A.A.-R., M.M., M.P.), Rothschild Foundation Hospital, Paris, France
Language :
English
Title :
ACCESS: ACtive Catheterization for EndovaScular TreatmentS-A First-in-Human, Single-Center, Nonrandomized, Open Clinical Study of the G60 Active Device for Endovascular Neurointerventions.
Couture T, Szewczyk J. Design and experimental validation of an active catheter for endovascular navigation. J Med Devices 2017;12:011003 CrossRef
Lahlouh M, Chenoune Y, Blanc R, et al. Aortic arch anatomy characterization from MRA: a CNN-based segmentation approach. 2022 IEEE 19th International Symposium on Biomedical Imaging (ISBI) March 28–31, 2022; Kolkata, India. 1–5 CrossRef management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2015;46:3020–35 CrossRef Medline
Madhwal S, Rajagopal V, Bhatt DL, et al. Predictors of difficult carotid stenting as determined by aortic arch angiography. J Invasive Cardiol 2008;20:200–04
Badrou A, Tardif N, Chaudet P, et al. Simulation of multi-curve active catheterization for endovascular navigation to complex targets. J Biomech 2022;140:111147. CrossRef Medline
Simmons CR, Tsao EC, Thompson JR. Angiographic approach to the difficult aortic arch: a new technique for transfemoral cerebral angiography in the aged. Am J Roentgenol Radium Ther Nucl Med 1973;119:605–12 CrossRef Medline
Bendszus M, Koltzenburg M, Burger R, et al. Silent embolism in diagnostic cerebral angiography and neurointerventional procedures: a prospective study. Lancet Lond Engl 1999;354:1594–97 CrossRef
Powers WJ, Derdeyn CP, Biller J; American Heart Association Stroke Council, et al. 2015 American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early
Knox JA, Alexander MD, McCoy DB, et al. Impact of aortic arch anatomy on technical performance and clinical outcomes in patients with acute ischemic stroke. AJNR Am J Neuroradiol 2020;41:268–73 CrossRef Medline
Shapiro M, Raz E, Nelson PK. Aortic arch variants: a practical guide to safe and timely catheterization. Interv Neurol 2018;7:544–55 CrossRef Medline
Sidiq M, Scheidecker E, Potreck A, et al. Aortic arch variations and supra-aortic arterial tortuosity in stroke patients undergoing thrombectomy: retrospective analysis of 1705 cases. Clin Neuroradiol 2023;33:49–56 CrossRef
Snelling BM, Sur S, Shah SS, et al. Unfavorable vascular anatomy is associated with increased revascularization time and worse outcome in anterior circulation thrombectomy. World Neurosurg 2018;120:e976–e983 CrossRef Medline