TY - JOUR
T1 - New concept in neurovascular navigation
T2 - technical description and preclinical experience with the Bendit 17 and Bendit 21 microcatheters in a rabbit aneurysm model
AU - Berenstein, A
AU - Cabiri, O
AU - Broussalis, Erasmia
AU - Hufnagl, Clemens
AU - Killer-Oberpfalzer, Monika
N1 - Broussalis, Hufnagl, Killer-Oberpfalzer: Institute of Neurointervention, Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University Salzburg, Salzburg, Austria.
PY - 2022
Y1 - 2022
N2 - BACKGROUND: Endovascular treatment of intracranial vascular diseases, such as aneurysms, is often challenged by unfavorable vascular anatomy. The Bendit Steerable Microcatheter (Bendit Technologies, Tel Aviv, Israel) has bending and torqueing capabilities designed to improve navigation and stability during device delivery, with or without a guidewire. We describe our preclinical experience with the Bendit 17 and Bendit 21 microcatheters in a rabbit aneurysm model.METHODS: Bifurcation and side wall aneurysms were created surgically in six New Zealand rabbits. We attempted to navigate Bendit devices through the vasculature and enter the aneurysms without a guidewire. Various positions within the aneurysm were selectively explored. Angiographic imaging was used to visualize catheterization, navigation, vascular manipulations, and placement of coils, stents, and intrasaccular devices.RESULTS: We successfully navigated the Bendit microcatheters to all aneurysms without a guidewire. We successfully recanalized a nearly occluded carotid artery and navigated the Bendit through a braided stent. In contrast, we were unable to navigate a comparator device with a guidewire as effectively as the Bendit. Coils were introduced at different locations within the aneurysm and could be pushed, pulled, and repositioned with the Bendit tip. Finally, we used the Bendit to deliver intrasaccular devices designed for terminal aneurysms to treat side wall aneurysms.CONCLUSIONS: Bendit's bending and torqueing abilities, combined with its stability in the bent position, enable quick navigation and optimal deployment of devices. Clinical studies are necessary to determine whether these navigation advantages lead to more efficient treatment of intracranial and peripheral aneurysms.
AB - BACKGROUND: Endovascular treatment of intracranial vascular diseases, such as aneurysms, is often challenged by unfavorable vascular anatomy. The Bendit Steerable Microcatheter (Bendit Technologies, Tel Aviv, Israel) has bending and torqueing capabilities designed to improve navigation and stability during device delivery, with or without a guidewire. We describe our preclinical experience with the Bendit 17 and Bendit 21 microcatheters in a rabbit aneurysm model.METHODS: Bifurcation and side wall aneurysms were created surgically in six New Zealand rabbits. We attempted to navigate Bendit devices through the vasculature and enter the aneurysms without a guidewire. Various positions within the aneurysm were selectively explored. Angiographic imaging was used to visualize catheterization, navigation, vascular manipulations, and placement of coils, stents, and intrasaccular devices.RESULTS: We successfully navigated the Bendit microcatheters to all aneurysms without a guidewire. We successfully recanalized a nearly occluded carotid artery and navigated the Bendit through a braided stent. In contrast, we were unable to navigate a comparator device with a guidewire as effectively as the Bendit. Coils were introduced at different locations within the aneurysm and could be pushed, pulled, and repositioned with the Bendit tip. Finally, we used the Bendit to deliver intrasaccular devices designed for terminal aneurysms to treat side wall aneurysms.CONCLUSIONS: Bendit's bending and torqueing abilities, combined with its stability in the bent position, enable quick navigation and optimal deployment of devices. Clinical studies are necessary to determine whether these navigation advantages lead to more efficient treatment of intracranial and peripheral aneurysms.
KW - Rabbits
KW - Animals
KW - Intracranial Aneurysm/diagnostic imaging
KW - Embolization, Therapeutic/methods
KW - Stents
KW - Angiography
KW - Carotid Arteries
U2 - 10.1136/neurintsurg-2022-018644
DO - 10.1136/neurintsurg-2022-018644
M3 - Original Article (Journal)
C2 - 35292566
SN - 1759-8478
VL - 15
SP - 172
EP - 175
JO - JOURNAL OF NEUROINTERVENTIONAL SURGERY
JF - JOURNAL OF NEUROINTERVENTIONAL SURGERY
IS - 2
ER -