{
  "abstract": "Introduction/Purpose To demonstrate applications of delivery-assist catheters (DCs) beyond conventional use in stroke. Classically, DCs are tapered support catheters designed to aid the advancement of large-bore aspiration catheters for mechanical thrombectomy. This submission describes multiple additional applications.Materials and Methods Our first case demonstrates severe vasospasm following perimesencephalic subarachnoid hemorrhage. Vasospasm of the A1 segment was refractory to administration of intra-arterial verapamil and nitroglycerin. A medium Balt Carrier delivery catheter was advanced over a Synchro Soft microguidewire to position the Carrier system beyond a severely spastic A1 segment into the A2 segment. The Carrier system was left in place for 2 minutes before removal, allowing for Carrier angioplasty of the spastic vessel. Our second case shows moderate-to-severe stenosis at the right transverse-sigmoid sinus junction. A coaxial system comprising a HiPoint 88 catheter over a Tenzing 8 delivery catheter and a Synchro microguidewire was used to cross the stenotic segment.Results The graphic shows a pre-Carrier angioplasty AP injection of the right internal carotid artery (top left), revealing severe segmental stenosis in the right A1 segment (black arrow) resistant to vasodilatory cocktail. A post-Carrier angioplasty AP injection of the right internal carotid artery (top right) shows significant improvement in the right ACA luminal caliber and arteriovenous transit time after using the DC system. Similarly, an AP venous-phase injection (bottom left) demonstrates the focal severe stenosis at the right transverse-sigmoid sinus junction (black arrow), making it difficult to advance the guide catheter alone for stent deployment. Use of the DC system was successful in passing the guide catheter beyond the stenotic segment (bottom right), allowing sufficient access to deploy a stent across the stenosis.Conclusion Here we exemplify using DCs in severe vasospasm unresponsive to vasodilatory cocktails to perform angioplasty on the spastic segment, restoring luminal caliber and improving arteriovenous transit. DCs can help advance the large-bore guide catheter past stenosis, such as during venous sinus stenting. At our institution, DCs have also been successfully employed in cases like tandem occlusion caused by carotid stenosis, where they helped reduce the ledge effect between co-axial devices, making it easier to cross a stenotic lesion that a microwire alone could not pass. Additionally, DCs have been used in tandem occlusion caused by dissection to introduce a large-bore system beyond the dissected segment for mechanical thrombectomy and stenting.Disclosures A. Rezayev: None. J. Morales: None. A. Mohamed: None. D. Sasaki-Adams: None. S. Patro: None.Abstract E-282 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "A Rezayev"
    },
    {
      "affiliations": [
        "Neurointerventional Radiology, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "J Morales"
    },
    {
      "affiliations": [
        "Neurointerventional Radiology, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "A Mohamed"
    },
    {
      "affiliations": [
        "Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "D Sasaki-Adams"
    },
    {
      "affiliations": [
        "Neurointerventional Radiology, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "S Patro"
    }
  ],
  "title": "E-282 A Paradigm shift in use of delivery-assist catheters: applications beyond stroke",
  "uid": "c982e7f2-f6e8-5d2c-8600-8855b5b5254c"
}