Clinical and Simulated Experiences With the Bendit Articulating/Steerable Microcatheter in Endovascular Treatment: 2-Dimensional Operative Video.

Unfavorable vascular anatomy poses a challenge to endovascular navigation when treating neurovascular diseases. To address this, Bendit Technologies developed the Bendit21 articulating/steerable microcatheter with bending and torquing capabilities that improve navigability and stability during device delivery. The Bendit21 has an outer diameter of 3.1 Fr ( 0.041 ''), an inner diameter of 0.021 '', and shaft length of 157 cm. It is compatible with guidewires up to 0.018 ''. We describe a series of our clinical and simulated experiences using Bendit devices to successfully navigate difficult vascular scenarios. The participants and any identifiable individuals consented to publication of his/her image, and the patients consented to the procedures. The accompanying video describes the uses of the Bendit21 catheter, now approved by the FDA. We demonstrate the use of the Bendit microcatheter to traverse a tortuous vertebral artery. Although it can be used in conjunction with a guidewire, it was used in another case to wirelessly bypass the ophthalmic artery to reach the A1 segment of the anterior cerebral artery. The device was also effective in traversing a vertebral artery stent which was located distally, making access challenging. The Bendit was used to effectually treat 2 cases of aneurysms in which all previous treatment attempts had failed. In addition, the Bendit microcatheter accurately delivered an intrasaccular device into an anterior communicating artery aneurysm and was also successfully implemented in the treatment of a dural arteriovenous malformation through the cortical veins. We show that the Bendit articulating/steerable microcatheter allows unique navigability, and precise, stable positioning can be critical advantages in the treatment of various intracranial vascular lesions.