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A New Hemostasis Valve for Neuroendovascular Procedures

A hemostasis valve is routinely used in neuroendovascular procedures to decrease the risk of thromboembolism 1,2. Recently, a new hemostasis valve that is designed to minimize blood loss has been introduced. We report our initial experience in using this new hemostasis valve. In neuroendovascular procedures, a hemostasis valve is commonly used for continuous irrigation of guide and microcatheters to decrease the risk of thromboembolism 1,2,3. A conventional hemostasis valve has a rotating seal at the end, which is turned open or closed each time a wire or microcatheter/guidewire is introduced or extracted. Often this results in significant back bleeding. When a rotating seal is adjusted suboptimally during a wire or microcatheter manipulation, leakage of pressurized saline from the end of a hemostasis valve results in stagnation of blood within a guiding catheter, which becomes a potential source of emboli during a procedure. The Guardian Haemostasis Valve (Zerusa Limited, Galway, Ireland) is a new hemostasis valve that is designed to minimize blood loss during interventional procedures by minimizing the opening time of the valve during wire or microcatheter insertion. A continuous sealing mechanism during wire or microcatheter positioning minimizes blood loss and stagnation of blood within the guide catheter. We report our initial experience with the Guardian hemostasis valve.