Microguidewire Looping to Traverse Stented Parent Arteries of Intracranial Aneurysms
Journal of Korean Neurosurgical Society
; : 262-268, 2017.
Article
em En
| WPRIM
| ID: wpr-152693
Biblioteca responsável:
WPRO
ABSTRACT
OBJECTIVE: Stents are widely used in coil embolization of intracranial aneurysms, but on occasion, a microcatheter must traverse a stented segment of artery (so-called trans-cell technique) to select an aneurysm, or double stenting may necessary. In such situations, microguidewire passage and microcatheter delivery through a tortuous stented parent artery may pose a technical challenge. Described herein is a microguidewire looping technique to facilitate endovascular navigation in these circumstances. METHODS: To apply this technique, the microguidewire tip is looped before entering the stented parent artery and then advanced distally past the stented segment, with the loop intact. Rounding of the tip prevents interference from stent struts during passage. A microcatheter is subsequently passed into the stented artery for positioning near the neck of aneurysm, with microguidewire assistance. The aneurysm is then selected, steering the microcatheter tip (via inner microguidewire) into the dome. RESULTS: This technique proved successful during coil embolization of nine saccular intracranial aneurysms (internal carotid artery [ICA], 6; middle cerebral artery, 2; basilar tip, 1), performing eight trans-cell deliveries and one additional stenting. Selective endovascular embolization was enabled in all patients, resulting in excellent clinical and radiologic outcomes, with no morbidity or mortality directly attributable to microguidewire looping. CONCLUSION: Microguidewire looping is a reasonable alternative if passage through a stented artery is not feasible by traditional means, especially at paraclinoid ICA sites.
Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Pais
/
Artérias
/
Artérias Carótidas
/
Stents
/
Aneurisma Intracraniano
/
Mortalidade
/
Artéria Cerebral Média
/
Embolização Terapêutica
/
Aneurisma
/
Pescoço
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Journal of Korean Neurosurgical Society
Ano de publicação:
2017
Tipo de documento:
Article