The baboon (Papio anubis) extracranial carotid artery: An anatomical guide for endovascular experimentation

BACKGROUND: As novel endovascular strategies are developed for treating neurological disease, there is an increasing need to evaluate these techniques in relevant preclinical models. The use of non-human primates is especially critical given their structural and physiological homology with humans. In order to conduct primate endovascular studies, a comprehensive understanding of the carotid anatomy is necessary. We therefore performed a detailed examination of the vessel lengths, lumen diameters and angles of origin of the baboon extracranial carotid system. METHODS: We characterized the extracranial carotid system often male baboons (Papio anubis, range 15.1–28.4 kg) by early post-mortem dissection. Photographic documentation of vessel lengths, lumen diameters, and angles of origin were measured for each segment of the carotid bilaterally. RESULTS: The common carotid arteries averaged 94.7 ± 1.7 mm (left) and 87.1 ± 1.6 mm (right) in length. The average minimal common carotid lumen diameters were 3.0 ± 0.3 mm (left) and 2.9 ± 0.2 mm (right). Each animal had a common brachiocephalic artery arising from the aorta which bifurcated into the left common carotid artery and right braciocephalic artery after 21.5 ± 1.6 mm. The vascular anatomy was found to be consistent among animals despite a wide range of animal weights. CONCLUSIONS: The consistency in the Papio anubis extracranial carotid system may promote the use of this species in the preclinical investigation of neuro-interventional therapies

EP62 Endovascular transcarotid artery revascularization using the walrus balloon guide catheter: safety and feasibility from multicenter experience

IntroductionThe Walrus Balloon Guide Catheter (BGC) is a new generation of BGC, designed to bypass limitations of conventional BGCs in mechanical thrombectomy.ObjectivesTo analyze the Walrus BGC for cervical carotid disease (CCD) using the endovascular transcarotid artery revascularization (eTCAR) technique.AimsSafety and feasibility from a multicenter experience.MethodsRetrospective analysis of prospectively-maintained multicenter datasetsResults105 patients with high-grade CCD (median carotid stenosis of 83%) were included. Navigating the Walrus BGC in the common carotid artery (CCA) was successful in all cases despite type 3/bovine arch anatomy in 26.7%. Emergent treatment for cervical tandem occlusion along with mechanical thrombectomy for acute ischemic stroke was performed in 35.2% of the cases, with successful recanalization rate (TICI 2b/3) of 81.1%. Utilizing femoral access in 81.9% of the patients, carotid stenting was performed in all cases except 4 (angioplasty only); adjunct angioplasty and distal protection devices were used in 86.7% and in 53.4% of the cases, respectively. Flow arrest was utilized in the majority of the procedures (87.6%), with successful stent deployment achieved in all cases. No major ischemic or Walrus BGC related complications, myocardial infarction or mortality was encountered. Last follow-up mRS of 0–2 was 70.5% overall and 98.2% in elective eTCAR.ConclusionWe present a large multicenter experience of eTCAR technique utilizing the Walrus BGC. In all cases elective or emergent carotid stenting was successful with proximal flow arrest or flow reversal with or without distal protection device with favorable safety profile on follow-up.DisclosureJan-Karl Burkhardt, consultant for Q`Apel Medical, Longeviti Neuro Solution