Neurointervention.  2022 Nov;17(3):143-151. 10.5469/neuroint.2022.00248.

Safety and Effectiveness of the Novel Catheter 3.0 System for Diagnostic Cerebral Angiography: A Pilot Study

• Kwon B
• Lee KB
• Yoon JT
• Choi JH
• Lee DH
• Song Y

• KMID: 2535949
• DOI: http://doi.org/10.5469/neuroint.2022.00248

Abstract

Purpose
The purpose of this study was to evaluate the safety and effectiveness of a new angiographic system (Catheter 3.0 system) using a 5 French (Fr), large-bore angiography catheter, a 0.032-inch stiff guidewire, and a continuous flushing system in diagnostic cerebral angiography.
Materials and Methods
This retrospective study included 30 consecutive patients who underwent transfemoral cerebral angiography using the Catheter 3.0 system from October 2019 to March 2020. As the control group, we included 30 consecutive patients examined before the Catheter 3.0 system was introduced. Procedural outcomes, including technical success, procedure time, dose metrics, procedure-related complications, and image quality were reviewed and analyzed.
Results
All transfemoral cerebral angiographies were performed for a diagnosis of unruptured intracranial aneurysms. The Catheter 3.0 system showed a significantly shorter fluoroscopy time (6.2 vs. 9.7 minutes, P=0.008) and lower fluoroscopy dose (387.2 vs. 614.4, P=0.002) compared with the conventional 4-Fr catheter system. The Catheter 3.0 system also showed better results in terms of procedural time (21.0 vs. 22.5 minutes, P=0.072) and technical success rate (98.1% vs. 94.0%, P=0.078), although a statistical significance was not reached. The complication rate and qualitative assessment of the digital subtraction angiography (DSA) image quality were similar between the two groups.
Conclusion
The Catheter 3.0 system using a 5 Fr catheter with a large inner diameter was convenient, effective, and safe compared with the conventional system in diagnostic cerebrovascular angiography.

Keyword

Cerebral angiography; Catheters; Intracranial aneurysm

Figure

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  Fig. 1. Components and configuration of the Catheter 3.0 system. Grafia: Sungjin-Hitech, Suwon, Korea, Anguis: Sungjin-Hitech, Suwon, Korea.

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  Fig. 2. Box plots of procedural outcomes between the Catheter 3.0 system and the conventional catheter system, demonstrating procedure time (A), total fluoroscopy time (B), total fluoroscopy dose (C), and total radiation dose (D). The top of the box represents the 75th percentile, the bottom of the box represents the 25th percentile, and the line in the middle represents the 50th percentile. Circles and asterisks represent the “outlier” and “extreme values”, respectively.

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  Fig. 3. Representative cases using the Catheter 3.0 system in tortuous vessels. (A) A patient had a marked tortuosity in the supraaortic neck vessel, which prevented stable and safe catheterization of the left vertebral artery. The guidewire leading in front of the catheter prevented the wedging of the catheter tip against the vessel wall and kickback of the catheter during contrast injection. (B) Despite flow competition from the contralateral vertebral artery, the aneurysm at the superior cerebellar artery origin of the basilar artery was well-visualized on the left vertebral arteriogram. (C) Catheterization of the left external carotid artery with marked tortuosity. The guidewire that entered the occipital artery guided the catheter toward the occipital artery without dislodging during contrast injection. (D) Good opacification of the feeders of the sigmoid sinus dural arteriovenous fistula arising from the occipital and middle meningeal arteries.

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