Distal microcatheter placement using the Asahi Chikai TM 0.008-inch micro-guidewire for liquid embolic material delivery: A technical note.

INTRODUCTION: Management of vascular malformations requires microcatheter manipulation through distal tortuous arterial feeders less than a millimetre in diameter, to permit safe and effective embolization at the fistula or nidus location. The Asahi ChikaiTM 0.008 inch micro-guidewire recently introduced in the United States was used to evaluate microcatheter torque, support and safety in distal microcatheter navigation.

METHODS: The use of the Asahi Chikai 0.008 inch micro-guidewire in conjunction with flow-guided, and over the wire microcatheters was evaluated in 25 neuroendovascular cases over a 1 year period. It involved single operator usage for endovascular microcatheter embolization of intracranial vascular malformations listed below. The study evaluated angiographic evidence of distal microcatheter positioning, subsequent obliteration of the fistula at the location and complications if any.

RESULTS: The micro-guidewire was used in microcatheter embolization of 10 vein of Galen malformations, 11 brain and head & neck arteriovenous malformations, 2 spinal and 2 cranial dural arteriovenous fistula. Good flow directed and over the wire microcatheter placement using the Asahi ChikaiTM 0.008 inch micro-guidewire was possible across the spectrum of cases achieving optimum catheterization and safe embolization in all. There were no micro-guidewire or microcatheter related vessel spasm, dissection, or perforation during their combined or individual manipulation, contrast or embolic extravasation on fluoroscopy or post- embolization angiograms CONCLUSION: The Asahi ChikaiTM 0.008 inch micro-guidewire is a safe, sturdy micro-guidewire which provides good torque in distal arterial anatomy while providing microcatheter support and maintaining tip configuration on repeated use.