First-in-human trial of Center Wire for neuroendovascular therapy to avoid guidewire-related complications

Abstract

Background An exchange maneuver is useful for the delivery of devices to target vessels. However, hemorrhagic complications can occur due to vessel perforation during an exchange maneuver. In addition, the exchange is often challenging due to unfavorable anatomy. Center Wire is an exchange-length wire with a nondetachable stent that was developed to improve navigation and stability during exchange maneuvers. The aim of this study is to investigate the safety and efficacy of Center Wire of the anchor wire technique during neuroendovascular treatment. Methods Ten patients with intracranial aneurysms were treated after signing a Certified Review Board-approved consent. Anchor wire technique was used in all patients to navigate catheters to the target vessel for aneurysm treatment. Results Anchor wire technique was successfully applied in all 10 cases using Center Wire. One device-related incident of vasospasm occurred which was asymptomatic. No device-related dissection, perforation, or thromboembolic events occurred. One patient had intraoperative aneurysm rupture during coil placement which was treated immediately without clinical consequences. Two patients had postoperative ischemic strokes due to thrombotic occlusion of branches originating from the aneurysm which were unrelated to the device. Conclusions This first-in-human trial of Center Wire demonstrated the safety and efficacy of the anchor wire technique for neuroendovascular treatment in a strictly regulated prospective registry trial.

Clinical consequence of vessel perforations during endovascular treatment of acute ischemic stroke

“…In a small case study, Matsumoto et al described an anchor wire technique using a basket-shaped microwire which adheres to the vessel to stabilize the exchange of EVT devices near the target vessel to reduce manipulation induced vessel perforations. 26 The clinical outcome of vessel perforations is poor. Potentially, the discontinuation of EVT before reperfusion is a major factor leading to worse clinical outcome.…”