Selective coil embolization through flow-directed microcatheter for intracranial arteriovenous malformations

Horie, Nobutaka; Hayashi, Kentarō; Morikawa, Minoru; Nagata, Izumi

doi:10.1007/s00701-012-1287-3

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…Particularly in situations whereby the tip of the microcatheter is not well visualized, such as when it is within a nest of coils, there may be a risk of advancing the pusher wire outside of the microcatheter and potentially injuring the aneurysm wall. Horie et al have demonstrated that the Marathon microcatheter can be used to deploy detachable coils, but suggest that only Electro Detach Coils (Kaneka, Osaka, Japan) can be used because the Marathon only has one distal marker [4]. We show that the detachment process is safely performed with other coils, but may take more time as serial attempts to detach the coil are made as the coil is gradually and in a stepwise fashion advanced out of the microcatheter.…”

Section: Discussionmentioning

confidence: 78%

Aneurysm Coil Embolization Using a 1.5-Fr Distal Outer Diameter Microcatheter

2014

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The current assortment of microcatheters widely used for aneurysm coil embolization may not be well suited for several anatomic variants, including excessive vascular tortuosity and small aneurysms less than 3 mm. Longer microcatheters designed with a smaller caliber that can accommodate and deliver coils may be of use in these situations. This case series and literature review illustrates the advantages and limitations of the Marathon microcatheter (Covidien, Irvine, CA, USA) when used for coil embolization of cerebral aneurysms. Despite some technical compromises including the distal marker, length, and the risk of buckling, the Marathon microcatheter was able to adequately deliver coils to achieve satisfactory occlusion of cerebral aneurysms. We found unique advantages with regards to length and smaller distal outer diameter (OD). These results may serve as a guide for the further development of a microcatheter used for coil embolization that has the features of a smaller distal OD and longer length.

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Section: Discussionmentioning

confidence: 78%

Aneurysm Coil Embolization Using a 1.5-Fr Distal Outer Diameter Microcatheter

2014

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“…The tip of a microcatheter is hidden in the coil mass to make a dense coil mass, but ED coil is precisely positioned for detachment in such situation because it does not depend on the visibility of even distal tip of the microcatheter as well as the proximal marker. The fact that the ED coil is well applicable through Marathon catheter is already described by Horie et al .,[ 9 10 ] though it is not combined with Onyx infusion in their experiences. They used ED coil through Marathon catheter to treat vascular diseases of peripheral vessels such as AVM and dural arteriovenous fistulas (AVF) to block a feeder with coils alone or to reduce feeding flow before the NBCA injection from the same catheter.…”

Section: Discussionmentioning

confidence: 99%

Use of detachable coils without the need of a double marker microcatheter: Technical note

et al. 2018

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When using detachable coils for cerebral aneurysm embolization, it is necessary to place a microcatheter with radiopaque markers at 2 sites (tip and 3 cm proximal from the tip) in most cases. Detachable coils that can be positioned independently from the proximal marker may facilitate new applications utilizing their characteristics. Herein, we report 2 cases that were treated with new applications. Detachable coils that function to electrically detect the moment they come out of the microcatheter were used. In one patient with a large aneurysm with an irregular shape, coil embolization was applied by advancing the catheter more than 3 cm from the aneurysm neck to the caudally protruded compartment near the proximal end of the neck, which was difficult to reach with the coil. In the other patient with cerebral arteriovenous malformation (AVM), microcatheters for AVM without a proximal marker were used for coil embolization before Onyx injection: Coil embolization was applied through one microcatheter to a site more proximal than the tip of the other microcatheter, followed by Onyx injection through the distal catheter, by which the nidus was continuously penetrated from the initiation of injection, obtaining an effect similar to that of the plug and push technique. Through the use of detachable coils, which are not dependent on the visibility of the proximal marker, the limitation of catheter positioning is reduced and the applicable types of catheter increase, which may facilitate to enable its use for new clinical indications.

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“…Moreover, liquid embolics have a risk of distal migration into the venous system or normal branches in such cases. 8 – 10) To address these issues, detachable coils that can be delivered through the Marathon ® catheter provide safe and efficient embolization for selected AVMs, 11) as well as for distal aneurysms, AVFs, and hypervascular tumors with tortuous and narrow vessels.…”

Section: Discussionmentioning

confidence: 99%

A Novel Method for Super-selective Coil Embolization Using an Extremely Soft Bare Coil through a Liquid Embolic Delivery Microcatheter

Horie

Hayashi

Morikawa

et al. 2015

Neurol. Med. Chir.(Tokyo)

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Endovascular coil embolization for intracranial aneurysms, arteriovenous malformations (AVMs), dural arteriovenous fistulas (AVFs), and hypervascular tumors are recognized as an effective adjunctive or curative treatment. In this setting, it is sometimes difficult to navigate a coil delivery microcatheter to the target point of a tiny, tortuous vessel. We herein present a case series of a novel method that enabled super-selective coil embolization using an extremely soft bare, electrodetachable coil (ED extrasoft® coil) through a liquid embolic delivery microcatheter (Marathon®). The Marathon® catheter was successfully placed at the target point of the tiny, tortuous vessel, and coil embolization was achieved in all 16 patients with 9 AVMs, 2 distal aneurysms, 2 AVFs, and 3 meningiomas. The primary ED extrasoft® coil and delivery wire have a very small radius, and the coil is rapidly detachable with an alarm notice from the generator even under Marathon® with one marker. We believe that this technique can provide safe and efficient embolization for selected patients.

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Selective coil embolization through flow-directed microcatheter for intracranial arteriovenous malformations

Cited by 6 publications

References 8 publications

Aneurysm Coil Embolization Using a 1.5-Fr Distal Outer Diameter Microcatheter

Aneurysm Coil Embolization Using a 1.5-Fr Distal Outer Diameter Microcatheter

Use of detachable coils without the need of a double marker microcatheter: Technical note

A Novel Method for Super-selective Coil Embolization Using an Extremely Soft Bare Coil through a Liquid Embolic Delivery Microcatheter

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