J Neurointerv Surg. 2025 Nov 25:jnis-2025-024491. doi: 10.1136/jnis-2025-024491. Online ahead of print.
ABSTRACT
BACKGROUND: The Magic microcatheter is a commonly used flow directed microcatheter for endovascular neurointervention. This microcatheter family is one of the smallest and softest microcatheters on the market, suitable for embolization of fistulous lesions in pediatric patients. Despite the Magic catheter being designed for adult size and lengths, our institution regularly utilizes these catheters for pediatric and neonatal embolizations. In some geographical regions, the Magic microcatheter remains contraindicated for use in pediatrics and neonates.
METHODS: We reviewed our practice’s database for all cases of pediatric neurointerventions that used the Magic catheter between March 1991 and December 2022. We describe the demographic characteristics of this cohort, frequency of Magic catheter use, adjunct devices, complications, and clinical outcomes.
RESULTS: 341 pediatric patients who underwent 924 neurointervention procedures were identified for review. 2184 Magic microcatheters were used. Average patient age at the time of the procedure was 3.3 years (IQR 7.9). Treated pathologies included vein of Galen malformations (48%), intracranial arteriovenous malformations (42%), extracranial arteriovenous malformations (4.4%), and arteriovenous fistulas (6%). Magic microcatheter technical success was achieved in 803 cases (87%). There were 43 (4.7%) intraprocedural complications, including 4 (0.4%) retained catheters and 14 intraprocedural hemorrhagic events (1.5%). There were two periprocedural mortalities. The most common liquid embolic agent used was n-butyl cyanoacrylate.
CONCLUSIONS: The Magic microcatheter appears to be safe and effective in pediatric embolization procedures. However, there remains a technology gap in the development of flow directed catheters specifically designed and proportioned for use in pediatric patients.
PMID:41290399 | DOI:10.1136/jnis-2025-024491
