title: Headway Duo microcatheter for cerebral arteriovenous malformation embolization with n-BCA.
abstract: BACKGROUND
  Cerebral arteriovenous malformations (AVMs) are uncommon vascular lesions, and hemorrhage secondary to AVM rupture results in significant morbidity and mortality. AVMs may be treated by endovascular embolization, and technical advances in microcatheter design are likely to improve the success and safety of endovascular embolization of cerebral AVMs.
  
  
  OBJECTIVE
  To describe our early experience with the Headway Duo microcatheter for embolization of cerebral AVMs with n-butyl-cyanoacrylate (n-BCA).
  
  
  METHODS
  Consecutive patients treated by endovascular embolization of a cerebral AVM with n-BCA delivered intra-arterially through the Headway Duo microcatheter (167 cm length) were identified. Patient demographic information, procedural details, and patient outcome were determined from electronic medical records.
  
  
  RESULTS
  Ten consecutive patients undergoing cerebral AVM embolization using n-BCA injected through the Headway Duo microcatheter were identified. Presenting symptoms included headache, hemorrhage, seizures, and weakness. Spetzler Martin grades ranged from 1 to 5, and AVMs were located in the basal ganglia (2 patients), parietal lobe (4 patients), frontal lobe (1 patient), temporal lobe (1 patient), an entire hemisphere (1 patient), and posterior fossa (1 patient). 50 arterial pedicles were embolized, and all procedures were technically successful. There was one post-procedural hemorrhage that was well tolerated by the patient, and no other complications occurred. Additional AVM treatment was performed by surgery and radiation therapy.
  
  
  CONCLUSIONS
  The Headway Duo microcatheter is safe and effective for embolization of cerebral AVMs using n-BCA. The trackability and high burst pressure of the Headway Duo make it an important and useful tool for the neurointerventionalist during cerebral AVM embolization.
authors.affiliation: Department of Radiology, Interventional Neuroradiology Division, Stanford University Hospital, Stanford, California, USA.
authors.forename: Jeremy J
authors.identifier: http://orcid.org/0000-0003-1055-8000
authors.initials: JJ
authors.lastname: Heit
authors.affiliation: Department of Radiology, Interventional Neuroradiology Division, Stanford University Hospital, Stanford, California, USA.
authors.forename: Abigail G S
authors.initials: AG
authors.lastname: Faisal
authors.affiliation: Department of Radiology, Interventional Neuroradiology Division, Stanford University Hospital, Stanford, California, USA.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Telischak
authors.affiliation: Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA.
authors.forename: Omar
authors.identifier: http://orcid.org/0000-0002-8311-2336
authors.initials: O
authors.lastname: Choudhri
authors.affiliation: Department of Radiology, Interventional Neuroradiology Division, Stanford University Hospital, Stanford, California, USA.
authors.forename: Huy M
authors.initials: HM
authors.lastname: Do
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D057785:Catheters; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D004659:Enbucrilate / Q000008:administration & dosage*; D005260:Female; D005625:Frontal Lobe; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010296:Parietal Lobe; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D004659:Enbucrilate
keywords: Arteriovenous Malformation; Catheter; Liquid Embolic Material