Treatment of Recurrent Aneurysm of the Internal Carotid Artery-poster Communicating Artery Using the Marathon Microcatheter: A Case Report

OBJECTIVE: We report the case of an aneurysm of the recurrent internal carotid artery (ICA)-posterior communicating artery (PCoA) treated using a liquid embolic delivery microcatheter (MC; Marathon). CASE PRESENTATION: A 66-year-old female previously presented with subarachnoid hemorrhage, which had been treated using coil embolization for a ruptured ICA-PCoA aneurysm. She was referred to our hospital because the aneurysm recurred 13 years after treatment. Angiography revealed a de novo lobulated aneurysm at the ICA-PCoA bifurcation with a relatively thickened PCoA branching from the neck of the aneurysm. We performed coil embolization after stent placement with the Neuroform Atlas in the range of the ICA terminus and the PCoA. However, the coils were unequally distributed and it was necessary to navigate the MC to the aneurysm within the stent through the PCoA. We successfully approached the aneurysm using the Marathon. We additionally inserted six ED coils into the aneurysm and achieved favorable embolization. CONCLUSION: The Marathon is useful for passage of a stent deployed in a small-caliber artery.