Loop microcatheter technique for coil embolization of paraclinoid aneurysms

Jia, Zhen; Yun, Seok-Kweon; Sheen, Jae Jon; Kim, Joong-Goo; Lee, Chae Woon; Suh, Dae Chul

doi:10.1007/s00701-018-3642-5

Cited by 16 publications

(15 citation statements)

References 12 publications

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“…Currently available microcatheters/microguidewires may not be able to reach the desired position, which presents a challenge for embolization 4 8 14. We were able to coil two giant aneurysms that could not be treated with other microcatheters because it was not possible to gain access to the distal vessels even with a loop in the aneurysm or due to tortuous vessels, or where the carotid artery exiting the aneurysm is in an unfavorable angle, where present catheter/guidewires combination were unable to get access.…”

Section: Discussionmentioning

confidence: 95%

“…Our early first-in-human results highlight the ability of the Bendit21 to be navigated through complex vasculature without delays or vessel damage. The acute-angle branching in the internal carotid artery has presented a challenge for catheterization with conventional microcatheters 11 14 15. Likewise, the extradural (V3) curve of the vertebral artery is difficult to reproduce in microcatheters of a fixed shape 3.…”

Section: Discussionmentioning

confidence: 99%

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Clinical experience with the Bendit steerable microcatheter: a new paradigm for endovascular treatment

Killer‐Oberpfalzer

Chapot

Orion

et al. 2022

J NeuroIntervent Surg

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BackgroundVessel tortuosity poses a challenge during endovascular treatment of neurovascular lesions. Bendit Technologies (Petah Tikva, Israel) has developed flexible, steerable microcatheters designed with unique bending and torquing capabilities.ObjectiveTo describe our first-in-human trial of Bendit21.MethodsBendit21 was used in our exploratory, prospective, multicenter, open-label, single-arm clinical study, and in two compassionate use cases. Procedures were conducted at four centers in Austria, Germany, Israel, and the United States between May 2021 and March 2022, in patients with neurovascular conditions. The primary endpoints were device-related safety events, successful navigation through the neurovasculature, and, when intended, successful delivery of contrast or therapy.ResultsTwo patients with giant aneurysms were treated successfully under compassionate use approval. The clinical study included 25 patients (mean age: 63.4±11.8 years; 32.0% female). Fourteen patients (56.0%) had aneurysms, two had arteriovenous malformations/fistulas (8.0%), one had a stroke (4.0%), four (16.0%) had intracranial stenosis, and four (16.0%) had other conditions. Bendit21 was used without a guidewire in 12/25 (48.0%) procedures. Bendit21 was successfully navigated through the vasculature without delays or spasms in all cases (100%). Contrast was delivered as intended in 7/7 (100%) cases. Therapeutic devices were delivered successfully with Bendit as intended in 14/18 (77.8%) cases; four deficiencies occurred in three patients with aneurysms, in whom delivery of coils, an intrasaccular device, or a flow diverter was attempted. There were no device-related safety events or mortalities.ConclusionsOur initial clinical experience with the Bendit21 microcatheter demonstrates its usefulness in achieving technical success in patients with challenging neurovascular conditions.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Clinical experience with the Bendit steerable microcatheter: a new paradigm for endovascular treatment

Killer‐Oberpfalzer

Chapot

Orion

et al. 2022

J NeuroIntervent Surg

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“…Stabilization of the microcatheter loop via a partially inflated balloon We already described the loop microcatheter technique for paraclinoid aneurysms. 26 However, the loop technique alone can sometimes be unstable while the coils are introduced into the aneurysm. In this situation, we additionally supported the microcatheter loop using a balloon catheter (Scepter XC™; Microvention, Tustin, CA, USA) with a double-lumen for guidewire and ballooning.…”

Section: Ballooning Strategiesmentioning

confidence: 99%

Microcatheter Stabilization Technique Using Partially Inflated Balloon for Coil Embolization of Paraclinoid Aneurysms

et al. 2021

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Purpose: Coil embolization of paraclinoid aneurysms should be simple, safe, and effective considering the benign nature of the aneurysm. Here, we present a microcatheter stabilization technique using a partially inflated balloon for the treatment of paraclinoid aneurysms.Materials and Methods: This retrospective study included 58 patients who underwent balloon-assisted coiling (BAC) for unruptured paraclinoid aneurysms at a tertiary neuro-intervention center between January 2019 and March 2020. We applied a technique to stabilize the microcatheter’s position using the modified BAC technique in paraclinoid aneurysms showing various projections around the ophthalmic curve of the internal carotid artery. The basic concept of the technique is to place a partially inflated balloon just distal to the aneurysm neck and support the distal curve of the microcatheter using the proximal bottom of the balloon. Immediate radiological outcomes were analyzed, and clinical outcomes were evaluated with modified Rankin Scale (mRS) scores.Results: The BAC was successfully performed in 51 of 58 patients (88%). We treated the remaining seven patients by switching to stent-assisted coiling. We obtained a 37% mean packing density resulting in favorable occlusion in all 58 aneurysms (complete occlusion in 35 and residual neck in 23). There were no intraprocedural thromboembolic or hemorrhagic events except one that revealed an asymptomatic infarction after the procedure (1.7%). Magnetic resonance angiography follow-up was performed in 37 patients at an average of 11.8 months, in which 11 minor recurrences (29.7%) were found. There was no major recurrence nor retreatment. The mRS score was 0 in all patients during a mean follow-up of 17.7 months (range, 12–25 months).Conclusion: The modified balloon-assisted coiling technique using a partially inflated balloon was safe and effective and could serve as an option for treating paraclinoid aneurysms.

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“…In cerebral aneurysm coil embolization, the stability of the catheter and ease of its insertion are elements that directly affect the difficulty and safety of the procedure. [1][2][3] For cerebral aneurysm embolization, the catheter is shaped using steam or a hot gun after determining the positions of the aneurysm and parent artery by 3D imaging techniques such as 3D DSA. However, the images are different from the anatomical structures in scale and experience is needed to imagine the route of catheter passage in the body.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Preoperative Simulation Using a Stereolithographic 3D Printer in Cerebral Aneurysm Coil Embolization

Onda¹,

Nonaka²,

Nomura³

et al. 2021

NOUSHINKEI KEKKANNAI TIRYOU

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We present a preoperative simulation of cerebral aneurysm coil embolization using a hollow model of cerebral blood vessels created by a stereolithography (SLA) 3D printer. Case Presentation:The patient was a 66-year-old woman. During follow-up, coil embolization was planned for an expanding paraclinoid aneurysm. A hollow cerebral vascular model was created preoperatively using an SLA 3D printer.The catheter was malleable and inserted into the hollow model, which enabled the surgeons to confirm its movement, stability, and ease of insertion. In the surgical procedure, the catheter was easily inserted into the aneurysm without reshaping. The procedure was completed without stability problems. Conclusion:The use of a hollow model of cerebral blood vessels was useful as a preoperative simulation and improved the safety of the procedure.Keywords▶ 3D printing, unruptured aneurysm, preoperative simulation, catheter shaping This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.

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Loop microcatheter technique for coil embolization of paraclinoid aneurysms

Abstract: Loop microcatheter technique allowed safe and stable coil packing for paraclinoid aneurysms. The same procedural concept is also being used for aneurysms in other vascular territories.

Cited by 16 publications

References 12 publications

Clinical experience with the Bendit steerable microcatheter: a new paradigm for endovascular treatment

Clinical experience with the Bendit steerable microcatheter: a new paradigm for endovascular treatment

Microcatheter Stabilization Technique Using Partially Inflated Balloon for Coil Embolization of Paraclinoid Aneurysms

Usefulness of Preoperative Simulation Using a Stereolithographic 3D Printer in Cerebral Aneurysm Coil Embolization

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