Utilization of high-support pre-shaped guiding catheter (SEL-E and IWATE series) in neuroendovascular treatment

BackgroundGuiding catheters (GCs) are crucial platforms for neuroendovascular procedures. High-support pre-shaped guiding catheters (HPGCs) were designed to address access difficulties in complex anatomies. Given its versatility in neuroendovascular treatment, we report our single-center experience with the HPGCs.MethodsA single-center retrospective analysis was conducted on 154 neuroendovascular procedures using the HPGCs between January 2017 and February 2024. The HPGCs include three models: SEL-E, IWATE, and IWATE-L. The cases were categorized into three scenarios: addressing access failure, serving as a platform for posterior circulation interventions, and supporting angioplasty for neck-thoracic lesions. Data on procedural success, complications, and anatomical characteristics were collected.ResultsSuccessful access was achieved in 92.4% of access failure cases (n = 79). Successful recanalization was achieved in 60.5% of thrombectomy cases, with a median patient age of 89 years and complex vascular anatomies involving a type 3 aorta in 94.2% of cases. For posterior circulation procedures (n = 67), the treatment success rate was 97.0%, utilizing a strategy that combined the HPGCs with intermediate catheters to prevent large-bore GCs from entering the vertebral artery. In angioplasty for neck-thoracic lesions (n = 8), technical success was achieved in 75% of patients.ConclusionsThe pre-shaped, high-support features of the HPGCs demonstrated effectiveness and safety in access failure cases while enabling broader utilization in posterior circulation and neck-thoracic lesion procedures.