The LVIS devices are self-expanding nickel titanium, single-wire braid, compliant, closed-cell implants that can be deployed and retrieved by a single operator using the delivery system (figure 1 ). The LVIS Junior device (figure 1A ) is available in diameters of 2.5 and 3.5 mm and in unconstrained lengths between 10 and 30 mm. The LVIS device (figure 1B ) is available in 3.5, 4.5, and 5.5 mm diameters ranging in lengths between 10 and 30 mm. The LVIS Junior device is delivered through a standard microcatheter with an internal diameter of 0.017’ (Headway 17, Microvention/Terumo, Tustin, CA). The LVIS device is delivered through a standard microcatheter with an internal diameter of 0.021’ (Headway 21, Microvention/Terumo, Tustin, CA). These braided microstents provide substantially greater metal surface area coverage (LVIS 23%–27% and LVIS Junior 17%–23%) than do the predicate laser-cut Nitinol hypotube-based microstents (Neuroform, Stryker Neurovascular, Fremont, CA, Enterprise, Codman Neurovascular, Raynham, MA and Solitaire, Medtronic, Irvine CA; 6.5%–9.5%).
Headway 21
Manufactured by Terumo
Sourced in United States, Japan
Headway 21 is a laboratory equipment product manufactured by Terumo. It is designed for centrifugal processing of biological samples. The device features a compact design and supports a range of rotors and accessories to accommodate various sample volumes and processing requirements.
Automatically generated - may contain errors
Lab products found in correlation
Headway 17, by Terumo (2 mentions)
Trevo pro 18, by Stryker (2 mentions)
Neuroform, by Stryker (1 mentions)
Echelon 10, by Medtronic (1 mentions)
Excelsior sl 10, by Stryker (1 mentions)
Excelsior 1018, by Stryker (1 mentions)
Xt 17, by Stryker (1 mentions)
Guider softip, by Stryker (1 mentions)
Azurion, by Philips (1 mentions)
Axiom artis, by Siemens (1 mentions)
Excelsior xt27, by Stryker (1 mentions)
Sofia flow plus, by Terumo (1 mentions)
6 protocols using headway 21
1
LVIS Devices: Compliant Neurovascular Implants
2
Microcatheter X-ray Absorption and Thermal Shaping
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Eight types of microcatheters, always available in our angiography room, were simultaneously imaged with cone-beam CT in their boxes to measure X-ray absorption values. Products included Excelsior SL-10 (Stryker, Kalamazoo, Michigan, United States), XT-17 (Stryker), Excelsior 1018 (Stryker), Headway DUO (Terumo, Tokyo, Japan), Headway 17 (Terumo), Headway 21 (Terumo), Phenom 17 (Medtronic, Irvine, California, United States), and Echelon 10 (Medtronic). Next, five microcatheters (Excelsior SL-10, Excelsior 1018, Headway DUO, Headway 17, and Phenom 17) that were available for this study were thermally formed with a hot-air gun, and the following experiments were performed.
3
p64 MW HPC Deployment for Aneurysm
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All patients signed the informed consent at least 24 h before the procedure. All treatments were performed under general anesthesia. A 7F short sheath (Terumo, Tokyo, Japan) with a 7F guiding catheter (Guider Softip, Stryker, Kalamazoo, MI, USA) was introduced via right-sided femoral access in combination with an intermediate catheter (e. g., Navien A + 058, Medtronic, Dublin, Ireland). Heparin (3000 IU unfractionated heparin) was administered intravenously after groin puncture. All pressurized flushing solutions were heparinized (5000 IU/L). The p64 MW HPC was deployed via a Prowler Select Plus (Cerenovus, Irvine, CA, USA), a Trevo Pro 18 (Stryker Neurovascular, Fremont, CA, USA), or a Headway 21 (MicroVention Terumo, Aliso Viejo, CA, USA) microcatheter. The diameter and length of the p64 MW HPC were chosen based on two- and three-dimensional measurements of the diameter of the parent artery, the distance between the proximal and distal landing zones, the discrepancies between the diameters of the two landing zones, and the width of the aneurysm neck.
4
Microcatheter Selection for p48MW Delivery
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The p48MW HPC requires a 0.021′ microcatheter for delivery. In the majority of patients, the Prowler Select Plus (0.021′; Cerenovus, Irvine, CA, USA) was used. However, related to repeated difficulties during catheterization of challengingly curved vessels, the Headway 21 (0.021′; MicroVention Terumo, Aliso Viejo, CA, USA) was tried and then used as a favored microcatheter for p48MW delivery in later interventions.
5
Endovascular Flow Diversion Procedures
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All treatments were performed in patients under general anesthesia with a 6 F guiding catheter or 8 F guiding catheter with a 5 F intermediate catheter in cases of severe vessel elongation, with guidance provided by bi-plane digital subtraction angiography (DSA) (Axiom Artis, Siemens, Erlangen, Germany; Azurion, Philips, Eindhoven). The standard approach included femoral access using short sheaths, predominantly on the right side. All FDs were deployed via Trevo Pro 18, Excelsior XT27 (Stryker Neurovascular, Kalamazoo, MI, United States), Headway 21 (MicroVention Terumo, Tokyo, Japan) or Prowler Select Plus (Cerenovus, Johnson & Johnson, New Brunswick, NJ, United States) microcatheters.
All patients undergoing FD procedures received intravenous administration of 3,000–5,000 IU heparin. Heparinized irrigation solutions were used in all catheters (5,000 IU unfractionated heparin/L). FD implantation was performed by the two most experienced interventionalists at each center.
All patients undergoing FD procedures received intravenous administration of 3,000–5,000 IU heparin. Heparinized irrigation solutions were used in all catheters (5,000 IU unfractionated heparin/L). FD implantation was performed by the two most experienced interventionalists at each center.
6
Modified ADAPT Clot Aspiration
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A SOFIA Flow Plus (Terumo, Tokyo, Japan) aspirator was navigated up to the proximal end of the clot using a coaxial Headway 21 microcatheter (Terumo). After beginning aspiration through a pump (Penumbra MAX pump; Penumbra, Almeda, CA, USA), the guiding balloon was inflated (modified A direct aspiration first pass technique [ADAPT]).[5 ] The SOFIA Flow Plus aspirator was withdrawn and retrieved into the guiding catheter. Then, the guiding balloon was deflated.
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