The "pipe-anchor" technique: A method for intra-aneurysmal loop reduction using a partially unsheathed pipeline stent.
Interv Neuroradiol
; : 15910199231169851, 2023 Apr 25.
Article
en En
| MEDLINE
| ID: mdl-37097896
ABSTRACT
PURPOSE:
Large aneurysms often present a challenge for endovascular navigation, as they may require utilization of "around-the-world" technique for distal access. In this study, we describe the use of a pipeline stent to stabilize the microcatheter allowing gradual unsheathing and straightening of the microcatheter within the aneurysm enabling stent deployment.METHODS:
A pipeline stent is partially deployed distal to the aneurysm, after using intra-aneurysmal loop ("around-the-world") to cross the aneurysm. Partially unsheathed, using its radial force and vessel wall friction to establish an anchoring point, the microcatheter is stabilized and pulled with the stent locked to gradually to allow loop reduction and microsystem straightening, allowing unsheathing as the microsystem is aligned with the inflow and outflow vessel.RESULTS:
Two patients harboring cavernous segment aneurysms (measuring 18 × 12â mm and 21 × 24â mm) were treated by 3.75 × 25â mm and 4.25 × 25â mm pipeline devices, respectively, using this technique, deployed through a Phenom 0.027" microcatheter. Patients did well clinically with no thromboembolic complications, as follow-up imaging demonstrated good wall apposition and appreciable contrast stagnation.CONCLUSION:
Anchoring for loop reduction was previously described using a non-flow diverter stents or balloon requiring additional devices and exchange maneuvers to deploy a pipeline. The "pipe anchor" technique describes the use of a partially deployed flow diverter system as an anchor. This report suggests that pipeline radial force, albeit low, is sufficient. We believe that this method is worthy of consideration in select cases as a first choice and can be valuable tool in the armamentarium of the endovascular neurosurgeon.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Interv Neuroradiol
Asunto de la revista:
NEUROLOGIA
/
RADIOLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos