ArticleNeurosurgery practice2025
Novel Small-Bore Preshaped Guiding Sheath for Transradial Anterior Circulation Interventions: A New Device and Technique.
Article in Neurosurgery practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
background and importanceThe transradial approach is increasingly used for neurointerventions; nevertheless, a large-bore system can lead to access site complications. To reduce these risks, we developed a novel radial-specific small-bore guiding sheath, the 4F Axcelguide Stiff-J-20. Here, we present the first case and technique using this device for an anterior circulation aneurysm. CLINICAL PRESENTATION: In this study, we used the 4F Axcelguide Stiff-J-20 guiding sheath (outer diameter, 2.03 mm/0.080″; inner diameter, 1.65 mm/0.065″; usable length, 115 cm) for 2 patients. This sheath features a 20-cm Simmonds-shaped bending zone, allowing catheterization of the high cervical internal carotid artery. Coil embolization was performed for 2 patients: a 59-year-old man with an unruptured right middle cerebral artery bifurcation aneurysm and 52-year-old man with an unruptured left ICA-posterior communicating artery aneurysm. After the 4F Axcelguide Stiff-J-20 was engaged in the target internal carotid artery, a triaxial system (4F Axcelguide Stiff-J-20/3.2F Tactics Intermediate Catheter/Single Microcatheter) was constructed. Coil embolization was performed using a simple technique. Intraprocedural system instability and catheter kinking did not occur. No patient experienced access-site complications, and the postprocedural course was uneventful.
conclusionThe 4F Axcelguide Stiff-J-20 guiding sheath can achieve sufficient stability and kink resistance, while reducing the risk of access site complications. This device could be a useful therapeutic option for neurointervention.
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