Abstract
BackgroundSupportive guide catheters are needed to navigate large endovascular devices through complex cerebral vasculature. The Q'Apel SelectFlex family of distal access guide catheters may eliminate the need for triaxial systems through a simplified biaxial approach with reduced costs and similar effectiveness as traditional systems.MethodsA retrospective review of patients who underwent neuroendovascular interventions using SelectFlex catheters at 4 US sites between April 2021 and August 2022 was performed. We assessed the ability to successfully access the target location (biaxially or triaxially), the need for a bailout intermediate catheter (when performed biaxially), and adverse events (AE) attributed to SelectFlex.ResultsA total of 366 patients (66.9% [245/366] female; mean age: 58.3 ± 13.3) who underwent a cerebrovascular intervention with the SelectFlex system were included. The procedures performed were aneurysm embolization (251/366, 68.6%; coiling: 130/366, 35.5%, flow diversion: 121/366, 33.1%), middle meningeal artery embolization (10.1%, 37/366), Woven EndoBridge deployment (7.9%, 29/366), ruptured arteriovenous malformation/dural arteriovenous fistula embolization (4.6%, 17/366), tumor embolization (2.7%, 10/366), carotid stenting (1.9%, 7/366), percutaneous transluminal angioplasty (1.6%, 6/366), venous sinus stenting (1.1%, 4/366), and parent vessel occlusion for trauma/aneurysm (0.5%, 2/366). Transfemoral and transradial access were each used in 180 (49.2%) cases. Successful placement occurred in 100% of cases (366/366). In cases performed biaxially, 4.1% (13/320) required the addition of an intermediate catheter. One SAE related to SelectFlex occurred (0.3%).ConclusionsThis study demonstrates good performance and safety with SelectFlex in a variety of neurointerventional procedures. SelectFlex may reduce the need for triaxial support.