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Peer-reviewedCC BYAJNR: American Journal of Neuroradiology

Role of Microcatheter Tip Position and Microguidewire Stiffness in Safe Neuroendovascular Navigation of Distal Vessels

  • Keiko Fukuda1
  • Kenichi Sakuta2
  • Yoshiki Hanaoka3
  • Amir Molaie4
  • Omar Selim1
  • Mahsa Ghovvati1
  • Taichiro Imahori5,6
  • Kentaro Suzuki7
  • Satoshi Tateshima1
  • Naoki Kaneko1
7 affiliations
  1. 1From the Department of Radiological Sciences (K.F., O.S., M.G., S.T., N.K.), David Geffen School of Medicine at UCLA, Los Angeles, California
  2. 2Department of Neurology (K. Sakuta), Jikei University School of Medicine, Tokyo, Japan
  3. 3Department of Neurosurgery (Y.H.), Shinshu University School of Medicine, Matsumoto, Japan
  4. 4Department of Neurology (A.M.), David Geffen School of Medicine at UCLA, Los Angeles, California
  5. 5Department of Neurosurgery (T.I.), Kitaharima Medical Center, Hyogo, Japan
  6. 6Center for Clinical Research and Innovation (T.I.), Kobe City Medical Center General Hospital, Kobe, Japan
  7. 7Department of Neurology (K. Suzuki), Nippon Medical School Hospital, Tokyo, Japan
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Abstract

BACKGROUND AND PURPOSE: Advancements in neuroendovascular devices have enabled greater access to distal, tortuous vasculature. However, this expanded capability also increases the risk of serious hemorrhagic complications during device navigation. The aim of the study is to quantify how microcatheter position and microguidewire stiffness affect tip contact force at a distal MCA segment. MATERIALS AND METHODS: A moderate-tortuosity silicone model of the MCA was used to evaluate three 0.014-inch Synchro SELECT microguidewires (Soft, Standard, and Support) with a TrevoTrak microcatheter positioned proximally in the M1 or distally in the M2 segment. Tip contact forces at the distal end of the M2 segment were recorded with a digital force gauge serving as a standardized surrogate for the distal vessel wall during motorized controlled wire advancement. From the force-distance curves, tip contact force slopes (mN/mm) and maximum tip contact forces (mN) were calculated and statistically compared across wire types and catheter positions. RESULTS: < .01). Distal microcatheter positioning consistently produced approximately 3- to 6-fold higher tip contact force slopes and higher maximum tip contact forces than proximal positioning. CONCLUSIONS: Microcatheter tip position and microguidewire stiffness were the primary determinants of the tip contact force transmitted to distal vessel segments during neuroendovascular navigation in this model. Stiffer microguidewires exert significantly greater tip contact force, particularly when the microcatheter is positioned near the distal segment. Maintaining the microcatheter tip proximally attenuates these forces and offers a simple strategy to reduce mechanic loading of fragile distal branches during distal access procedures.

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Cite

BibTeXRIS
BibTeX
@article{fukuda2026role,
  title = {{Role of Microcatheter Tip Position and Microguidewire Stiffness in Safe Neuroendovascular Navigation of Distal Vessels}},
  author = {Keiko Fukuda and Kenichi Sakuta and Yoshiki Hanaoka and Amir Molaie and Omar Selim and Mahsa Ghovvati and Taichiro Imahori and Kentaro Suzuki and Satoshi Tateshima and Naoki Kaneko},
  journal = {AJNR: American Journal of Neuroradiology},
  year = {2026},
  month = nov,
  doi = {10.3174/ajnr.a9315},
  url = {https://doi.org/10.3174/ajnr.a9315},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Role of Microcatheter Tip Position and Microguidewire Stiffness in Safe Neuroendovascular Navigation of Distal Vessels
AU  - Keiko Fukuda
AU  - Kenichi Sakuta
AU  - Yoshiki Hanaoka
AU  - Amir Molaie
AU  - Omar Selim
AU  - Mahsa Ghovvati
AU  - Taichiro Imahori
AU  - Kentaro Suzuki
AU  - Satoshi Tateshima
AU  - Naoki Kaneko
PY  - 2026
DA  - 2026/11/06
JO  - AJNR: American Journal of Neuroradiology
DO  - 10.3174/ajnr.a9315
UR  - https://doi.org/10.3174/ajnr.a9315
AB  - BACKGROUND AND PURPOSE: Advancements in neuroendovascular devices have enabled greater access to distal, tortuous vasculature. However, this expanded capability also increases the risk of serious hemorrhagic complications during device navigation. The aim of the study is to quantify how microcatheter position and microguidewire stiffness affect tip contact force at a distal MCA segment. MATERIALS AND METHODS: A moderate-tortuosity silicone model of the MCA was used to evaluate three 0.014-inch Synchro SELECT microguidewires (Soft, Standard, and Support) with a TrevoTrak microcatheter positioned proximally in the M1 or distally in the M2 segment. Tip contact forces at the distal end of the M2 segment were recorded with a digital force gauge serving as a standardized surrogate for the distal vessel wall during motorized controlled wire advancement. From the force-distance curves, tip contact force slopes (mN/mm) and maximum tip contact forces (mN) were calculated and statistically compared across wire types and catheter positions. RESULTS: < .01). Distal microcatheter positioning consistently produced approximately 3- to 6-fold higher tip contact force slopes and higher maximum tip contact forces than proximal positioning. CONCLUSIONS: Microcatheter tip position and microguidewire stiffness were the primary determinants of the tip contact force transmitted to distal vessel segments during neuroendovascular navigation in this model. Stiffer microguidewires exert significantly greater tip contact force, particularly when the microcatheter is positioned near the distal segment. Maintaining the microcatheter tip proximally attenuates these forces and offers a simple strategy to reduce mechanic loading of fragile distal branches during distal access procedures.
SN  - 0195-6108
SN  - 1936-959X
ER  -