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Directions for use
(cont.)
use, ensure the compatibility of the size of the embolic
microspheres to the chosen microcatheter size.
The compatible microsphere size range is indicated on
the microcatheter’s external packaging label and in
Table 2. Before use, confirm the size compatibility of
the coiled embolic material and supportive device and
the microcatheter. When introducing embolic coils or
material, do not use devices or materials exceeding the
maximal dimensions detailed in Table 2. Always check
the movement of the embolic material and supportive
device through a high-resolution fluoroscope and/or a
digital subtraction angiography monitor. Do not advance
or withdraw the microcatheter if any resistance is felt in
the blood vessel, especially while using embolic material.
Advance or withdraw the microcatheter, only after
the cause of resistance is determined through a high-
resolution fluoroscope and/or a digital subtraction
angiography monitor. Any quick and unreasonable
movement may cause the microcatheter to break/
rupture/separate, which may result in damage to the
vessel.
10.
Before inserting the microcatheter into additional
vessels, flush the microcatheter with sterile heparinized
saline solution. If any resistance is felt during the insertion
of the guide wire, do not advance the guide wire any farther
and replace the microcatheter. If there is any difficulty
in inserting the guide wire into the microcatheter hub,
the guide wire and/or the hub can be rotated slightly to
facilitate insertion.
WARNING:
When re-inserting the guide wire into the
microcatheter, verify the location of the guide wire tip
through a high-resolution fluoroscope and/or digital
subtraction angiography monitor. Any erratic movement
of the wire may cause mechanical damage to the
microcatheter, which may result in damage to the vessel.
11.
When the procedure is completed, carefully remove the
microcatheter together with the guiding catheter.
WARNING:
If any resistance is felt, do not remove the
microcatheter by force. Withdraw the microcatheter
carefully together with the guiding catheter. Removing
the microcatheter by force may result in the fracture of
the microcatheter, which may necessitate retrieval.
Instructions for Using a Power Injector with the Microcatheter
A power injector can be used to infuse a contrast media
through the microcatheter. Observe the warnings and
cautions given below. The flow rate depends upon factors
such as the viscosity of the contrast media, the type and
temperature of the media, the model and setting of the
power injector and how the injector is connected to the
microcatheter.
WARNING:
Do not use a power injector to infuse agents
other than contrast media, as the microcatheter may
become blocked.
The injection pressure must not exceed the maximum
injection pressure that corresponds to outer diameter of
each microcatheter tip (see Table 3 below).
Exceeding the maximal injection pressure may cause the
microcatheter to rupture.
Table 3: Operational Information
Catheter OD
(distal)
Usable Length
of catheter
(cm)
Maximum
Injection Pressure
Dead Space
Volume
[ml]
Flow Rate with Iodinated
Contrast Media
(300 mg/ml, 37°C)
[ml/sec]
2.4 Fr
105
6205 kPa
(900 psi)
0.48
2.1
130
0.54
1.7
150
0.59
1.5
2.7 Fr
105
6205 kPa
(900 psi)
0.56
3.1
130
0.64
2.6
150
0.7
2.4
2.8 Fr
105
6205 kPa
(900 psi)
0.62
3.9
130
0.71
3.4
150
0.78
3.1
• Under high-resolution fluoroscopy and DSA monitor,
inject a small amount of contrast media with a syringe and
confirm the flow of contrast media out of the microcatheter
tip before using the power injector.
• If an expansion of the microcatheter outer diameter
is observed during the injection, the pressure may have
exceeded the maximum pressure limit. In such a case, stop
the injection immediately.
• When securing the microcatheter in position, secure it by
the hub so that microcatheter shaft is not damaged. When
securing, do not hold the microcatheter shaft with forceps,
as this may result in microcatheter separation.
CAUTION:
If the microcatheter has been kinked or bent,
it must be replaced.
• Connect the power injector to the microcatheter using a
pressure-resistant extension tube.
• When re-inserting the guide wire after completion of
angiography, the microcatheter’s inner lumen should be
flushed with sterile heparinized saline solution.