Early multicenter experience with the Radical 7F guide catheter for neurointervention

Introduction Neurointerventional guide catheters are the outermost catheters used for stability and access for smaller catheters. Most guide catheters have distinct transition points of their mechanical properties, which may hinder their advancement into the cerebrovasculature. Here, we present first-in-human data of the 7F Radical guide catheter, which is manufactured using a polymer jacket to allow for continuous transition of mechanical properties along its length.Methods This multicenter retrospective study reviewed cases using the 7F Radical catheter. Details regarding pathology, technical failures, adverse events, and adjunct devices were collected. Images of catheter position were graded by a blinded neurointerventionalist for distal catheter position in the internal carotid artery (ICA), external carotid artery, and vertebrobasilar vasculature.Results Four institutions contributed 154 consecutive cases. Vascular access included the femoral (61.7%) and radial arteries (31.2%) and femoral vein (7.1%). The most common pathologies were cerebral aneurysms (56.5%) and subdural hematomas (13.6%). The guide catheter was used in a biaxial system in 76.6% of cases. For ICA access, the catheter was positioned in the proximal cavernous ICA or more distal in 69.2% of cases. There was one catheter-related adverse event of thrombus formation on the catheter tip and nine non-device-related adverse events. There was one case of the 7F Radical catheter being exchanged for an 8F guide for additional support.Conclusions The 7F Radical guide catheter is effective in establishing distal cerebrovascular access for neurointerventions with an acceptable safety profile. In select cases, an intermediate catheter may be omitted for a biaxial system.