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Microguidewire Looping to Traverse Stented Parent Arteries of Intracranial Aneurysms
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 microc...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Neurosurgical Society
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365287/ https://www.ncbi.nlm.nih.gov/pubmed/28264249 http://dx.doi.org/10.3340/jkns.2016.0707.009 |
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author | Cho, Young Dae Rhim, Jong Kook Yoo, Dong Hyun Kang, Hyun-Seung Kim, Jeong Eun Han, Moon Hee |
author_facet | Cho, Young Dae Rhim, Jong Kook Yoo, Dong Hyun Kang, Hyun-Seung Kim, Jeong Eun Han, Moon Hee |
author_sort | Cho, Young Dae |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-5365287 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Korean Neurosurgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-53652872017-03-28 Microguidewire Looping to Traverse Stented Parent Arteries of Intracranial Aneurysms Cho, Young Dae Rhim, Jong Kook Yoo, Dong Hyun Kang, Hyun-Seung Kim, Jeong Eun Han, Moon Hee J Korean Neurosurg Soc Technical Note 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. Korean Neurosurgical Society 2017-03 2017-03-01 /pmc/articles/PMC5365287/ /pubmed/28264249 http://dx.doi.org/10.3340/jkns.2016.0707.009 Text en Copyright © 2017 The Korean Neurosurgical Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Technical Note Cho, Young Dae Rhim, Jong Kook Yoo, Dong Hyun Kang, Hyun-Seung Kim, Jeong Eun Han, Moon Hee Microguidewire Looping to Traverse Stented Parent Arteries of Intracranial Aneurysms |
title | Microguidewire Looping to Traverse Stented Parent Arteries of Intracranial Aneurysms |
title_full | Microguidewire Looping to Traverse Stented Parent Arteries of Intracranial Aneurysms |
title_fullStr | Microguidewire Looping to Traverse Stented Parent Arteries of Intracranial Aneurysms |
title_full_unstemmed | Microguidewire Looping to Traverse Stented Parent Arteries of Intracranial Aneurysms |
title_short | Microguidewire Looping to Traverse Stented Parent Arteries of Intracranial Aneurysms |
title_sort | microguidewire looping to traverse stented parent arteries of intracranial aneurysms |
topic | Technical Note |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365287/ https://www.ncbi.nlm.nih.gov/pubmed/28264249 http://dx.doi.org/10.3340/jkns.2016.0707.009 |
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