eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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3/2020
vol. 15
 
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abstract:
Original paper

Efficacy and safety of guidewireless catheterization with a steerable microcatheter in patients scheduled for yttrium-90 radioembolization: a prospective multicenter trial

Zbigniew Serafin
1
,
Olivier Dudeck
2
,
Maciej Powerski
3
,
Florian Wolf
4
,
Ralph Drewes
3
,
Maciej Pech
3

1.
Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
2.
Center for Microtherapy, Klinik Hirslanden, Zurich, Switzerland
3.
Department of Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
4.
Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vien, Austria
Videosurgery Miniinv 2020; 15 (3): 503–510
Online publish date: 2020/01/21
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Introduction
A steerable, guidewireless microcatheter is of interest to interventional radiologists because it can improve effectiveness and reduce procedure timing and cost.

Aim
To assess the feasibility and safety of yttrium 90 radioembolization with a new steerable microcatheter without the need to use a guidewire.

Material and methods
A steerable microcatheter (Direxion; Boston Scientific, Natick, MA, USA) was prospectively used for yttrium-90 microsphere delivery in 50 patients (57 applications). The following factors were documented: vessel anatomy; shape and position of the guiding catheter; anticipated catheter position; technical success of catheterization; degree of difficulty in maneuvering; time to reach the target position; and complications.

Results
The microcatheter target position was in the right hepatic artery (n = 30, 53%), the middle hepatic artery (n = 4, 7%), the left hepatic artery (n = 19, 33%), or in a segmental artery (n = 4, 7%). Vessel catheterization was successful in 53 of 57 hepatic arteries (93%). The mean time to reach the target position was 53.3 ±53.0 s. The mean degree of difficulty in maneuvering the catheter to the target position was 2.3 ±1.3 (easy) on a 6-point scale. The only complication observed was mild vasospasm in 1 patient.

Conclusions
The Direxion steerable microcatheter is characterized by unique steerability, allowing yttrium 90 delivery to be performed safely without use of a guidewire.

keywords:

liver, radioembolization, steerable catheter

  
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