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Electrothermal Coil Detachment Failure in Flow Diverter-Assisted Coiling of a Small Blister Aneurysm: Technical Considerations and Possible Solutions

Flow diversion stenting combined with coiling offers both immediate protection from rebleeding for ruptured aneurysms and long-term stability for wide-necked or blister aneurysms. It is particularly useful for tiny ruptured aneurysms, alleviating the concern that small coils may prolapse between the...

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Autores principales: Pickett, Gwynedd E., Cora, Adela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Interventional Neuroradiology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261105/
https://www.ncbi.nlm.nih.gov/pubmed/33827155
http://dx.doi.org/10.5469/neuroint.2020.00444
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author Pickett, Gwynedd E.
Cora, Adela
author_facet Pickett, Gwynedd E.
Cora, Adela
author_sort Pickett, Gwynedd E.
collection PubMed
description Flow diversion stenting combined with coiling offers both immediate protection from rebleeding for ruptured aneurysms and long-term stability for wide-necked or blister aneurysms. It is particularly useful for tiny ruptured aneurysms, alleviating the concern that small coils may prolapse between the struts of conventional stents. We employed this technique in a very small, broad-based ruptured aneurysm of the internal carotid, jailing the coiling microcatheter with a Pipeline Embolization Device. However, coil detachment repeatedly failed, until we withdrew the detachment zone into the microcatheter. We suggest that if the tip of the coiling catheter is adjacent to the stent, contact between the junction zone of the coil and the high metal density of the flow diverter may prevent proper electrothermal coil detachment. Detachment can be undertaken successfully within the microcatheter, though care must be taken thereafter to fully push the detached coil tail into the aneurysm.
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spelling pubmed-82611052021-07-16 Electrothermal Coil Detachment Failure in Flow Diverter-Assisted Coiling of a Small Blister Aneurysm: Technical Considerations and Possible Solutions Pickett, Gwynedd E. Cora, Adela Neurointervention Case Report Flow diversion stenting combined with coiling offers both immediate protection from rebleeding for ruptured aneurysms and long-term stability for wide-necked or blister aneurysms. It is particularly useful for tiny ruptured aneurysms, alleviating the concern that small coils may prolapse between the struts of conventional stents. We employed this technique in a very small, broad-based ruptured aneurysm of the internal carotid, jailing the coiling microcatheter with a Pipeline Embolization Device. However, coil detachment repeatedly failed, until we withdrew the detachment zone into the microcatheter. We suggest that if the tip of the coiling catheter is adjacent to the stent, contact between the junction zone of the coil and the high metal density of the flow diverter may prevent proper electrothermal coil detachment. Detachment can be undertaken successfully within the microcatheter, though care must be taken thereafter to fully push the detached coil tail into the aneurysm. Korean Society of Interventional Neuroradiology 2021-07 2021-04-08 /pmc/articles/PMC8261105/ /pubmed/33827155 http://dx.doi.org/10.5469/neuroint.2020.00444 Text en Copyright © 2021 Korean Society of Interventional Neuroradiology https://creativecommons.org/licenses/by-nc/4.0/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/ (https://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 Case Report
Pickett, Gwynedd E.
Cora, Adela
Electrothermal Coil Detachment Failure in Flow Diverter-Assisted Coiling of a Small Blister Aneurysm: Technical Considerations and Possible Solutions
title Electrothermal Coil Detachment Failure in Flow Diverter-Assisted Coiling of a Small Blister Aneurysm: Technical Considerations and Possible Solutions
title_full Electrothermal Coil Detachment Failure in Flow Diverter-Assisted Coiling of a Small Blister Aneurysm: Technical Considerations and Possible Solutions
title_fullStr Electrothermal Coil Detachment Failure in Flow Diverter-Assisted Coiling of a Small Blister Aneurysm: Technical Considerations and Possible Solutions
title_full_unstemmed Electrothermal Coil Detachment Failure in Flow Diverter-Assisted Coiling of a Small Blister Aneurysm: Technical Considerations and Possible Solutions
title_short Electrothermal Coil Detachment Failure in Flow Diverter-Assisted Coiling of a Small Blister Aneurysm: Technical Considerations and Possible Solutions
title_sort electrothermal coil detachment failure in flow diverter-assisted coiling of a small blister aneurysm: technical considerations and possible solutions
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261105/
https://www.ncbi.nlm.nih.gov/pubmed/33827155
http://dx.doi.org/10.5469/neuroint.2020.00444
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