Comprehensive Assessment of the Vecta46 Intermediate Catheter for Neurovascular Interventions.

Background Advancements in neuroendovascular surgery with sophisticated catheters have enhanced outcomes in complex procedures. The FDA-approved Vecta46 intermediate catheter (IMC) by Stryker Corporation (Kalamazoo, MI) is used in various neurovascular interventions. Since its approval, the Vecta46 IMC has not been comprehensively studied. This study evaluates its safety, versatility, and efficacy in real-world multi-pathology applications. Methods We retrospectively reviewed 53 patients who underwent endovascular procedures with the Vecta46 IMC. We collected and analyzed demographic details, baseline characteristics, procedural specifics, and clinical outcomes. Results Among 53 cases, common comorbidities included hypertension (n = 25, 47.2%) and hyperlipidemia (n = 22, 41.5%). Antiplatelet use was noted in 43.4% (n = 23), and anticoagulant use in 13.2% (n = 7). Aneurysm treatments accounted for 56.6% (n = 30) of cases, followed by middle meningeal artery (MMA) embolization for chronic subdural hematomas (cSDHs) (18.9%) (n = 10), stroke thrombectomies (11.3%) (n = 6), Onyx embolization for dural arteriovenous fistulas (dAVFs) (7.5%) (n = 4), and arteriovenous malformations (AVMs) (5.7%) (n = 3). Flow diversion was the most common aneurysm treatment (56.7%) (n = 17). Most procedures were transradial (79.2%) (n = 42), primarily on the right side (88.7%) (n = 47), with verapamil used in 75.5% (n = 40). The mean number of vessels selected was 3.2±1.9, procedure duration was 102.4±66.8 minutes, fluoroscopy time was 43.6±31.1 minutes, contrast dose was 80.5±31.6 mL, and reference air kerma was 2114.0±1349.4 mGy. The Vecta46 was successfully navigated to the target vessel in 96.2% (n = 51) of cases. Intraprocedural complications included a nontarget vessel embolization, a thromboembolic event, and a non-flow-limiting focal dissection. No hemorrhagic complications or vessel irregularities occurred in the Vecta46 region. Post-procedural complications were minimal, with only forearm edema and an access site hematoma. Conclusions The Vecta46 catheter is an effective and safe tool for endovascular procedures, demonstrating versatility and reliability in neurovascular interventions.