Neuron™ System

June 15, 2017

Neuron™ family intracranial access system

 

Neuron™ family Recommendations

- Neuron 053 and 070 are compatible with short long sheaths with minimum IDs of 6F

- Placing Neuron 053 and 070 though at least two levels of tortuosity optimizes support

- Neuron max 088 is designed to be placed at the level of the cervical carotid

 

 

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Comprehensive access device portfolio

 

 

This is truly the only soft-tipped long sheath specifically designed for neurovascular use. This is the foundation of every Ischemic stroke treatment and a stable, widely compatible .088” delivery catheter useful to deliver a WIDE variety of devices. NeuronMAX 6F Long sheath comes packaged with dilator for access directly through the skin, if desired.

 

             - “Soft-Tipped, 6F Long Sheath”

             - Extra supportive proximal shaft for arch support

               (Full length stainless steel braid reinforced proximal support)

             - Flexible, soft tip designed for seamless delivery into high Cervical ICA over

               6F Select 90cm NeuronMAX + 6F 125cm BER Select

             - Distal shaft has hydrophilic coating for optimal trackability

             - Available in 80 and 90cm lengths with straight(STR) and multipurpose(MP) 

 

 Configurations

 

     ●  90cm Neuron MAX + 6F Select 125cm BER

             - Stroke Case :  Delivering ACE64, ACE, 5MAX, 4MAX

             - Balloon Assisted Coiling : PC400/RUBY

 

     ●  80cm Neuron MAX + 6F Select 105 BER

             - Delivering DDC : tortuous coil/stent or AVM treatment

             - Added Support for Neuron 070, Neuron 053

     

 

      ※ 90cm NeuonMAX + 6F 125cm Select is the GO-TO setup for nearly every stroke case.

          The 90cm will reach its target location in high cervical in the vast majority of ALL patients.

          The 80cm should only be used as additional support to another guide/intermediate catheter.

 

 

 

Shaft construction

 

 

 

 Optimizing stability with Neuron MAX 088

Penumbra System (Neuron MAX, dilator and 6F Select) work to gain rapid access from groin to high cervical.

The idea behind Neuron MAX SOFT TIP LONG SHEATH is that it allows safe placement into the HIGH CERVICAL ICA. This high position allows the long sheath to provide both unmatched support AND enhanced pushability of the inner device, WHATEVER that may be. This video demonstrated the difference in pushability when you place your long sheath in the HIGH CERVICAL vs a lower position.

 

 

 

Single therapy compatibility

 

Dual therapy compatibility

 

 

 

 

Neuron MAX comparision(competitors)

 

Dilator length

 

* 6F Long Sheath Configuration  – packaged with Crosscut Valve, RHV, and Dilator

 

 

 

 

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      Design goals

           

            - Increase the inner diameter to accommodate a wider variety of therapies

            - Improve the visibility of the catheter and treatment vessels

            - Maintain ability of Neuron 053 to provide robust anatomical support in tortuous anatomy

 

 

 

Shaft construction

                                                 - Economical 6F guide cath

                                                 - .070” lumen for dual micro therapy

                                                 - Must lock through 2 turns for stability

 

 

 

Designed to delivery the most complex multi device therapies

   

    - Hybrid shaft with multi-layer stainless steel braid re-enforced proximal support zone

    - Platinum reinforced distal shaft provides improved radiopacity

    - Distal shaft has hydrophilic coating for optimal trackability

 

 

 

 

Single therapy compatibility

 

 

Dual therapy compatibility

  

 

Sheath loading options

     1. Access directly through femoral sheath over .035”/.038” exchange-length guidewire

     2. Access by pre-loading Neuron into Neuron Peel-able Loading Sheath

     3. Access by pre-loading Neuron into Neuron Peel-able Loading Sheath using End-to-End        

         technique to minimize bleed-back

 

 

 

 

Using the peelable long sheath

 (peelable loading sheath is attached to the Neuron 070 delivery catheter packaging card.

 

   Peelable sheath

     

       1) Pre-load Neuron 070 Delivery Catheter into peel-able loading sheath.

       2) Insert peel-able loading sheath, with Neuron 070 loaded inside, into the femoral sheath.

       3) Advance Neuron 070 into the femoral sheath through the femoral sheath valve.

       4) Remove peel-able loading sheath from femoral sheath and peel to remove from Neuron 070.

             Note: Blood pressure may cause blood to squirt out from femoral sheath once diaphragm has been opened.                          Diaphragm will re-close once peel-able loading sheath has been removed from femoral sheath.

 

    Peelable Sheath w/ End-to-End Technique

 

       1) Pre-load Neuron 070 Delivery Catheter into peel-able loading sheath.

       2) Place peel-able loading sheath, with Neuron 070 loaded inside, flush with the femoral sheath valve.

       3) Advance Neuron 070 into the femoral sheath through the femoral sheath valve.

       4) Pull back and peel-able loading sheath from femoral sheath interface and peel to remove from

           Neuron 070.

              Note: Hold Neuron 070 very close to proximal end of peel-able loading sheath while loading catheter into                                avoid unnecessary catheter strain.

 

 

 

 

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          Design goals

    

               - Distal Flexibility, kink resistance, and coating

               - Locks through 3 turns into distal anatomy

               - Midshaft refinement with many material transitions

               - Proximal shaft support as good or better than conventional neurovascular guide,

                 NOT requiring long sheath for stability

 

 

 

Shaft construction

 

 

 

 

Feature(clinical advantage)

 

 

 

Higher anatomical placement

 

     - The neuron delivery catheter has been designed to use the neuro anatomy to improve support

        and help reduce back out

 

 

 

 

 

Optimized use of neuron 053

 

     ●  To protect Neuron 053’s unique distal flexible end :

               – Remove Neuron carefully from the packaging card and tube

               – Support the Neuron as it is introduced into the femoral sheath

 

        To easily introduce Neuron 053 into the femoral sheath :

                – Using an exchange-length .035” or .038” guide wire is preferable

              – Using the combination of the micro-catheter and micro-guide that will be used later

                 in the case is a good alternative

 

      ●  To select the great vessel of choice :

              – Select the great vessel of choice with the neuro diagnostic catheter with the

                 exchange length .035”/.038” guide wire inside.

              – Exchange out the neuro diagnostic catheter for the Neuron 053 Delivery Catheter.

 

      ●  To utilize Neuron’s unique design for optimal anatomical placement :

              – Advance Neuron until the distal end is around two-three levels of tortuosity

 

        To optimize flow and visualization through Neuron, especially when delivering

           devices with larger outer diameters:

– Use a 5 cc syringe              

              – Use 50/50 contrast


 

 

Single therapy compatibility

 

 

 

 

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In the box accessories

 

 

 

 

 

 

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