Abstract Number ‐ 9: Prospective Evaluation Of The Safety And Suitability Of The 088 Infinity Catheter For Radial Neurointerventions
Authors: Lee James , Nisar Taha , Memon Muhammad Z , Biswas Arundhati , Bach Ivo , Gupta Gaurav , Singla Amit , Sonig Ashish , Puri Ajit , Satti Sudhakar R , Ortega‐Gutierrez Santiago , Khandelwal Priyank 
Published: April 2023

Introduction
Transradial access (TRA) for neuroendovascular interventions has been associated with multiple benefits, including decreased risk of complications, faster recovery times, and improved overall patient satisfaction in comparison to transfemoral access (TFA). We sought to assess the safety and suitability of an 088 catheter, in this case the Infinity guide catheter, to understand the optimal patient population for utilization in neurointerventions. To our knowledge, this is the first prospective study to investigate procedural characteristics and complications associated with the use of an 088 catheter.

Methods
After obtaining approval from our Institutional Review Board, prospective patients undergoing neurointerventional procedures at our institution, beginning from December 2020 to present, were serially enrolled after evaluation for suitability for TRA by ultrasound visualization and measurement of vessel diameter. A prospective Excel database was generated on an encrypted and password‐protected computer, with variables including patient demographics, co‐morbidities, procedure type, catheter specifics, vessel diameter, procedural characteristics, TRA to TFA conversion, and complications.

Results
78 patients were enrolled over a 1.5 year study period (Table 1). The average patient age was 62.4 ± 16.1 years, with a moderate male predilection (46/78 (59%)). Procedure subtypes for enrolled patients included 36 (46.2%) patients who underwent stroke intervention, 6 (7.7%) aneurysm coil embolization, 9 (11.5%) aneurysm flow diversion, 5 (6.4%) carotid stenting, 5 (6.4%) AVM/AVF embolization, 4 (5.1%) tumor embolization, and 13 other procedures (9 (11.5%) MMA embolization, 3 (3.8%) vessel embolization, 1 (1.3%) aneurysm Onyx embolization). All procedures were performed via right radial access under direct ultrasound visualization. Average radial diameter was 2.97 ± 0.46mm and average fluoroscopy time was 48.99 ± 23.54 minutes. Parent vessel spasm was noted in 25/78 (32.1%) of cases and guide catheter kinking was noted in 4/78 (5.1%). TRA to TFA conversion was noted in 14/78 (17.9%) patients, primarily due to vessel tortuosity (57.1%; 8/14 cases). Minor complications included post‐procedural hand/wrist pain in 14/78 (17.9%) patients, and hand bruising in 6/78 (7.7%). Post‐operative vessel patency was noted in 71/78 (91%) of cases via ultrasound, with 57/78 (73.1%) having good pulsation noted on reverse Barbeau testing. No serious radial artery complications were noted. The overall rate of major complications was 7.7%, with two cases of ischemic stroke, contrast extravasation/intracerebral hemorrhage, and vessel rupture noted.

Conclusions
This prospective pilot study demonstrates the safety and suitability of the 088 Infinity guide catheter via TRA radial approach for neuroendovascular interventions. Further studies will be needed to assess the efficacy of the 088 Infinity in comparison to other 088 catheters, as well as the optimal settings by which we can minimize rates of TFA conversion and TRA‐related complications.