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E-051 Optimizing the injection of liquid embolics through microcatheters

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Introduction/purpose While advances in microcatheters have facilitated access to the distal neurovasculature, current embolization strategies have difficulty achieving long-term aneurysm occlusion. Liquid embolics have the potential to completely fill aneurysms,… Click to show full abstract

Introduction/purpose While advances in microcatheters have facilitated access to the distal neurovasculature, current embolization strategies have difficulty achieving long-term aneurysm occlusion. Liquid embolics have the potential to completely fill aneurysms, which may result in improved long-term occlusion. However, the only available liquid embolic agent for use in aneurysms, Onyx® HD-500, has a slow injection rate that requires multiple balloon inflation/deflation cycles. This limits delivery control and increases the likelihood of downstream occlusion. We sought to completely treat aneurysms in vitro with a novel liquid embolic PPODA-QT using a single balloon inflation/deflation cycle. This proposal evaluates PPODA-QT’s ability to fill a range of aneurysm sizes within a 5 min delivery window. Materials and methods PPODA-QT (viscosities from 400 to 1000cP) is simulated using silicone and glycerol solutions on the bench-top. Injection force was measured with a syringe pump fitted with a load cell. PPODA-QT flow rate, microcatheter inner diameter, and catheter length were varied during testing. The maximum injection force was limited to 20 lbs to improve ease-of-use and stay below typical catheter burst-pressures. Results 400cP solutions, with a catheter inner diameter (ID) of 0.023’, can fill ‘large’ aneurysms up to 2.8 ml within 3 min. ‘Medium’ aneurysms with a volume of up to 1.2 ml can be treated with 1000cP fluids in the same timeframe. Injection rates were verified using commercial catheter systems (table1). Conclusion PPODA-QT can treat aneurysms using a single balloon inflation/deflation at variable injection rates, up to 10X faster than Onyx, without the need for DMSO or DMSO-resistant microcatheters. 1000cP PPODA-QT is effectively delivered with catheters of 0.02’ or greater ID. Microcatheter selection for PPODA injection is therefore limited only by size (currently 2.6F for larger catheters). Further work is needed to refine the delivery of PPODA-QT prior to advancing to clinical trial. Disclosures C. Settanni: None. D. Shumway: None. T. Cotter: 5; C; Northern Arizona University. C. Gonzolez: 5; C; Northern Arizona University. T. Becker: 1; C; NIH. 4; C; Anubis. 5; C; Northern Arizona University. A. Ducruet: 5; C; Barrow Neurological Institute.

Keywords: balloon inflation; catheter; ppoda; injection; liquid embolics

Journal Title: Journal of NeuroInterventional Surgery
Year Published: 2018

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