Single institution early clinical experience with the Scepter Mini balloon catheter

Abstract

Background The use of liquid embolic agents in the endovascular treatment of dural arteriovenous (dAVFs) fistulas and brain arteriovenous malformations (AVMs) has become common practice. The use of dual lumen balloon microcatheters has greatly improved the efficacy of liquid embolization. The purpose of this series is to discuss our early experience with the Scepter Mini dual lumen balloon microcatheter. Methods A retrospective chart review was performed of all patients who underwent embolization with the Scepter Mini dual lumen balloon at a single institution. Technical details and procedural complications were recorded for each case. Results In total, 10 Scepter Mini dual lumen balloon microcatheters were used in nine patients. All patients except two were treated for AVMs. Technical success was achieved in all but one case where one balloon had to be discarded due to precipitation of the tantalum powder. Average vessel diameter where the balloon was inflated was 1.1 mm (0.8–2.4 mm). It provided flow arrest in 100% of cases with no cases of reflux of embolic material. Balloon “jump back” was found to occur in 44.4% (4/9) of cases. Seven out of nine cases used Onyx, and two cases used n-butyl cyanoacrylate. Conclusions The Scepter Mini is a new dual lumen balloon ideal for distal access and can be used for embolization with liquid embolic agents with a high degree of technical success. Its great benefit is the immediate and safe flow arrest of distal vasculature upon balloon inflation. One important consideration for effective embolization is early identification of balloon jump back.

Balloon-Assisted Coil Embolization and Balloon Angioplasty for Post Subarachnoid Hemorrhage Vasospasm: Initial Experience with Scepter Mini Balloon

“…In the first case, the available literature suggests that the catheters perform well with a high degree of technical success. 8,9 A study also supports its use for distal AVF in tortuous and small arterial feeders, especially in the pediatric population, where vessel diameters may be as small as 0.65 mm. 10 The versatility of the catheter and its different applications are also reported in another study, indicating 4 distinct uses: AVF embolization, balloon-occlusion with simultaneous embolization via a second microcatheter, diagnostic angiography with simultaneous balloon obstruction for flow control, and navigation support.…”

“…Due to its relatively recent release, the SMB has been mainly reported in scarce case reports and series, mostly involving patients treated with AVM embolization, while only a few articles report data regarding its use in the treatment of intracranial aneurysms. In the first case, the available literature suggests that the catheters perform well with a high degree of technical success [ 8 , 9 ]. A study also supports its use for distal AVF in tortuous and small arterial feeders, especially in the pediatric population, where vessel diameters may be as small as 0.65 mm [ 10 ].…”

Micro-balloon-assisted embolization of anterior cranial fossa dural arteriovenous fistula via a trans-ophthalmic approach — a technical report and case series

“…The MB can provide significant protection against reflux of LEA when sufficiently deployed distal to the retinal and posterior ciliary arteries, as close to the ACF fistula site as practical. Initial feedback from using the MB has been favorable, stating good navigability and flow arrest during several cases [ 17 , 20 , 21 ]. These positive factors were further supported by our experience.…”

“…While our two centers did not experience any notable drawbacks, some operators have noticed balloon kickback or “jump-back” and kinking of the balloon on inflation [ 20 , 21 ]. Both of these factors, however, can be countered.…”

Initial experience with the Scepter Mini catheter for the embolization of vascular malformations in the pediatric population

“…The existing literature regarding SMCs is currently limited in short case series, 4–9 none of which are purely pediatric. Pediatric vascular anatomy makes navigation more difficult compared with the adult patient and narrow vessels necessitate smaller outer-diameter (OD) catheters.…”