{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T11:34:35Z","timestamp":1771068875905,"version":"3.50.1"},"reference-count":12,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2013,5,14]]},"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Successful neuroendovascular treatments rely on microcatheter stability from guide catheter support. We present our experience using a new large-bore 0.058\u2005inch or 0.072\u2005inch inner diameter (ID) hyperflexible access catheter placed deep within the intracranial circulation during the neurointervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively reviewed all neurointerventions performed by the senior author during an 18-month period to identify patients in whom the Navien intracranial catheter was placed in an ultra-distal position, defined as beyond the clinoidal internal carotid artery (ICA) or V3 segment of the vertebral artery. Procedural data collected included parent artery tortuosity, technique for Navien advancement, intraprocedural Navien position and periprocedural complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The Navien, either 6\u2005F 0.072\u2005inch ID or 5\u2005F 0.058\u2005inch ID, provided ultra-distal large-bore access in the following 11 intracranial interventions: anterior circulation aneurysm treatment with Pipeline embolization device (PED) (n=3); posterior circulation aneurysm single-stage stent coiling (n=5); liquid embolization of arteriovenous malformations (n=2); PED coiling of posterior circulation aneurysm (n=1). The Navien was tracked into position over a Marksman microcatheter in 10\/11 cases and a Headway 27 microcatheter in one case. Intraprocedural Navien positions were as follows: supraclinoid ICA (n=2); mid M1 (n=1); V3\u2013V4 junction (n=2) (both using 6\u2005F Navien); distal V4 (n=3); proximal basilar (n=1); proximal-mid basilar (n=1); mid basilar (n=1). No significant catheter-related complications occurred.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The Navien is the newest hyperflexible access catheter that is highly trackable into ultra-distal intracranial positions. It maneuvers atraumatically, providing improved distal intracranial support for a variety of complex cerebrovascular interventions and preserves necessary ID for quality intraprocedural roadmaps and angiography.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/neurintsurg-2013-010772","type":"journal-article","created":{"date-parts":[[2013,6,1]],"date-time":"2013-06-01T20:31:11Z","timestamp":1370118671000},"page":"301-307","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Ultra-distal large-bore intracranial access using the hyperflexible Navien distal intracranial catheter for the treatment of cerebrovascular pathologies: a technical note"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6963-9799","authenticated-orcid":false,"given":"Li-Mei","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey P","family":"Colby","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judy","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael J","family":"Tamargo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander L","family":"Coon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,6,1]]},"reference":[{"key":"2025092911223722000_6.4.301.1","doi-asserted-by":"crossref","first-page":"E616","DOI":"10.1227\/01.NEU.0000324918.46479.DD","article-title":"Intracranial placement of a new, compliant guide catheter: technical note","volume":"63","author":"Park","year":"2008","journal-title":"Neurosurgery"},{"key":"2025092911223722000_6.4.301.2","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.surneu.2009.03.016","article-title":"Distal intracranial catheterization of patients with tortuous vascular anatomy using a new hybrid guide catheter","volume":"72","author":"Simon","year":"2009","journal-title":"Surg Neurol"},{"key":"2025092911223722000_6.4.301.3","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31820edfd8"},{"key":"2025092911223722000_6.4.301.4","doi-asserted-by":"publisher","DOI":"10.1136\/jnis.2010.002535"},{"key":"2025092911223722000_6.4.301.5","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2011-010041"},{"key":"2025092911223722000_6.4.301.6","first-page":"onsE329","article-title":"Direct radial artery access with the 070 neuron guide catheter for aneurysm coiling: a novel application of the neuron catheter for cerebral interventions","volume":"71","author":"Lawson","year":"2012","journal-title":"Neurosurgery"},{"key":"2025092911223722000_6.4.301.7","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2547"},{"key":"2025092911223722000_6.4.301.8","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2011-010256"},{"key":"2025092911223722000_6.4.301.9","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2012-010299"},{"key":"2025092911223722000_6.4.301.10","doi-asserted-by":"crossref","first-page":"1411e17","DOI":"10.1161\/01.STR.0000259824.10732.bb","article-title":"Brain aneurysms and arteriovenous malformations: advancements and emerging treatments in endovascular embolization","volume":"38","author":"Linfante","year":"2007","journal-title":"Stroke"},{"key":"2025092911223722000_6.4.301.11","doi-asserted-by":"crossref","unstructured":"Colby GP Lin LM Huang J . Utilization of the Navien distal intracranial catheter during 78 cases of anterior circulation aneurysm treatment with the Pipeline embolization device. J Neurointerv Surg 2013;5:iii16\u201321.","DOI":"10.1136\/neurintsurg-2013-010692"},{"key":"2025092911223722000_6.4.301.12","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2011-010234"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/neurintsurg-2013-010772","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T18:22:42Z","timestamp":1759170162000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/neurintsurg-2013-010772"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,1]]},"references-count":12,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2014,4,9]]},"published-print":{"date-parts":[[2014,5]]}},"alternative-id":["10.1136\/neurintsurg-2013-010772"],"URL":"https:\/\/doi.org\/10.1136\/neurintsurg-2013-010772","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6,1]]}}}