Endovascular Coiling of Fenestrated Vertebrobasilar Cerebral Aneurysms

Liao, Millie; Huynh, Kenneth; Cicilioni, K; Kumar, Ramachandran Pillai Promod

doi:10.5469/neuroint.2022.00360

Cited by 4 publications

(2 citation statements)

References 12 publications

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Section: Introductionmentioning

confidence: 99%

“…Several microcatheters on the market have this feature, such as the Echelon microcatheter from Medtronic Neurovascular, the Headway (17, 21, or 27) microcatheter from MicroVention, the SL10 microcatheter from Stryker Neurovascular, among others. [7,8] We describe the embolization technique that was used in a 36-year-old female patient, which involved the use of a microcatheter without a proximal radiopaque mark for coil embolization of an intracranial aneurysm.…”

Section: Introductionmentioning

confidence: 99%

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A simple but effective solution for proximal mark absence on some microcatheters in intracranial aneurysm embolization: Technical note

Figueroa-Sanchez,

Martinez,

Avalos-Montes

et al. 2023

Surgical Neurology International

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Background: Endovascular coil embolization is increasingly being used for the treatment of intracranial aneurysms and other pathologies such as arteriovenous (AV) malformations and AV fistulas. Appropriate embolization technique requires a microcatheter with two radiopaque marks, one proximal and one distal. We present an alternative coils deployment technique for intracranial aneurysms, using a microcatheter without a proximal radiopaque mark. Methods: We describe the technique for embolization that was used in a 36-year-old female patient, in which we used a microcatheter without a proximal radiopaque mark for coil embolization of an intracranial aneurysm. Results: We used a Headway Duo flow directed microcatheter for a coiling embolization of an intracranial aneurysm, solving the absence of the proximal radiopaque mark by cannulating the microcatheter with a Traxcess 0.014 microguidewire, and placing an external mark on the screen in the proximal portion of the microguidewire 30 mm radiopaque tip to indirectly mark the proximal mark of the microcatheter. Conclusion: There is scarce evidence supporting the use of microcatheters with no proximal radiopaque mark for coil embolization. This report attempts to disclose how an easy and simple technique can be used as a rescue method to solve the proximal radiopaque mark absence during endovascular coil release procedures. To the best of our knowledge, this technique has not been previously described; therefore, its use is not widespread among neurointerventionists.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A simple but effective solution for proximal mark absence on some microcatheters in intracranial aneurysm embolization: Technical note

Figueroa-Sanchez,

Martinez,

Avalos-Montes

et al. 2023

Surgical Neurology International

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An Approach for 3D Microprinting Soft Robotic Surgical Tools at 1.5 French Length Scales for Endovascular Interventions

Felix,

Young,

Andreou

et al. 2024

2024 IEEE 7th International Conference on Soft Robotics (RoboSoft)

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A comparison of endovascular coil systems for the treatment of small intracranial aneurysms

et al. 2023

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Background Endovascular coiling of small, intracranial aneurysms remains controversial and difficult, despite advances in technology. Methods We retrospectively reviewed data for 62 small aneurysms (<3.99 mm) in 59 patients. Occlusion rates, complications rates, and coil packing densities were compared between subgroups based upon coil type and rupture status. Results Ruptured aneurysms predominated (67.7%). Aneurysms measured 2.99 ± 0.63 mm by 2.51 ± 0.61 mm with an aspect ratio of 1.21 ± 0.34 mm. Brands included Optima (Balt) (29%), MicroVention Hydrogel (24.2%), and Penumbra SMART (19.4%) coil systems. Average packing density was 34.3 ± 13.5 mm3. Occlusion rate was 100% in unruptured aneurysms; 84% utilized adjuvant devices. For ruptured aneurysms, complete occlusion or stable neck remnant was achieved in 88.6% while recanalization occurred in 11.4%. No rebleeding occurred. Average packing density ( p = 0.919) and coil type ( p = 0.056) did not impact occlusion. Aspect ratio was smaller in aneurysms with technical complications ( p = 0.281), and aneurysm volume was significantly smaller in those with coil protrusion ( p = 0.018). Complication rates did not differ between ruptured and unruptured aneurysms (22.6 vs. 15.8%, p = 0.308) or coil types ( p = 0.830). Conclusion Despite advances in embolization devices, coiling of small intracranial aneurysms is still scrutinized. High occlusion rates are achievable, especially in unruptured aneurysms, with coil type and packing density suggesting association with complete occlusion. Technical complications may be influenced by aneurysm geometry. Advances in endovascular technologies have revolutionized small aneurysm treatment, with this series demonstrating excellent aneurysm occlusion especially in unruptured aneurysms.

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Endovascular Coiling of Fenestrated Vertebrobasilar Cerebral Aneurysms

Cited by 4 publications

References 12 publications

A simple but effective solution for proximal mark absence on some microcatheters in intracranial aneurysm embolization: Technical note

A simple but effective solution for proximal mark absence on some microcatheters in intracranial aneurysm embolization: Technical note

An Approach for 3D Microprinting Soft Robotic Surgical Tools at 1.5 French Length Scales for Endovascular Interventions

A comparison of endovascular coil systems for the treatment of small intracranial aneurysms

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