title: The versatile distal access catheter: the Cleveland Clinic experience.
abstract: BACKGROUND
  Vascular access is fundamental to any endovascular intervention. Concentric Medical has developed the Outreach Distal Access Catheter (DAC), which affords stable access at the target vessel modulating the forces at play within the thrombectomy device complex. The DAC is a device with novel access characteristics useful in a host of other types of clinical scenarios.
  
  
  OBJECTIVE
  To review our experience with the DAC family of devices, the theory, and method of use.
  
  
  METHODS
  A retrospective review of all cases in which the DAC was used during the period 2008 to 2010 was conducted and the cases classified by indication. Catheter-related complications were recorded. The use of the DAC in a variety of settings including intracranial stenting, aneurysm coil embolization, and arteriovenous malformation embolization is described.
  
  
  RESULTS
  The DAC was used in 103 procedures performed in 93 patients between August 2008 and February 2010. Indications included acute stroke, treatment of intracranial atherosclerosis, vasospasm therapy, arteriovenous malformation embolization, and aneurysm embolization. In those procedures, 113 catheters were used. No complications directly attributable to DAC use were identified.
  
  
  CONCLUSIONS
  The DAC is useful for gaining access to the cerebral vasculature, especially in patients with significant tortuosity or when re-access of distal vasculature is required multiple times.
authors.affiliation: Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors.forename: Alejandro M
authors.initials: AM
authors.lastname: Spiotta
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Hussain
authors.forename: Thinesh
authors.initials: T
authors.lastname: Sivapatham
authors.forename: Mark
authors.initials: M
authors.lastname: Bain
authors.forename: Rishi
authors.initials: R
authors.lastname: Gupta
authors.forename: Shaye I
authors.initials: SI
authors.lastname: Moskowitz
authors.forename: Ferdinand K
authors.initials: FK
authors.lastname: Hui
mesh_terms: D000328:Adult; D000368:Aged; D057785:Catheters; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000295:instrumentation*