Utilization of the Neuron 6 French 0.053 inch inner luminal diameter guide catheter for treatment of cerebral vascular pathology: Continued experience with ultra distal access into the cerebral vasculature

Objective: To describe our experience with very distal placement of the Neuron 6 F 0.053 inch inner luminal diameter guide catheter (Penumbra Inc, San Leandro, California, USA) within the intracranial and extracranial vasculature to allow treatment of various neurovascular pathologies. Previously, this was thought to be only possible with a microcatheter. Methods: 12 cases are presented in which traditional guide catheters were unable to successfully navigate tortuous anatomy or provide stable support for intervention. Results: The Neuron 6 F 0.053 inch inner luminal diameter delivery catheter (Penumbra) was placed in a very distal location within the internal carotid artery, external carotid artery and venous system enabling successful endovascular treatment of the intracranial pathology with no related neurological complications. Conclusion: All lesions were successfully treated through a microcatheter advanced in a coaxial fashion through the distally placed guide catheter. There were no complications related to the distal position of the guide catheter.