Use of Simple Neck Extension to Improve Guiding Catheter Accessibility in Tortuous Cervical Internal Carotid Artery for Endovascular Embolization of Intracranial Aneurysm: A Technical Note

Takata, Megumu; Fukuda, Hitoshi; Kinosada, Masanori; Miyake, Kosuke; Murao, Kenichi

doi:10.1016/j.wneu.2017.06.023

Cited by 9 publications

(4 citation statements)

References 15 publications

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“…The course of the cervical ICA itself greatly influences the catheterization of GC to the distal portion of the cervical ICA. 7) Among these, Type I cervical ICAs are extremely rare (according to our data), and GC catheterization is considered to be quite simple. Meanwhile, Z-shaped cervical ICAs are also relatively rare (10.1%), and they are frequently not amenable to ordinary catheterization.…”

Section: Discussionmentioning

confidence: 71%

“…The cervical ICA usually runs in the anterolateral to the postero-medial direction in the bifurcation of the common carotid artery. 7) We hypothesized that forging the tip of the GC into an S-shape could safely guide the GC more distally in the cervical ICA. This way, we evaluated the level of the GC tip during the coil embolization of anterior circulation cerebral aneurysms and compared the results between the conventional and S-shape GCs.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of S-Shaping of the Tip of the FUBUKI Guiding Catheter to Match the Shape of the Cervical Internal Carotid Artery in Anterior Circulation Cerebral Aneurysm Embolization

Indo,

Oya,

Yoshida

et al. 2024

JNET

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During cerebral aneurysm embolization of the anterior circulation, the guiding catheter (GC) should be placed as distally as possible in the cervical internal carotid artery (ICA) to secure the maneuverability of the microcatheter and distal access catheter. However, if the shape of the tip of the GC does not appropriately match the course of the ICA, blood stasis might occur. We investigated whether shaping the tip of the GC into an S-shape would allow more stable catheterization to the distal ICA than the conventional GC with an angled tip. Methods:We included patients with cerebral aneurysms of the anterior circulation who were treated at our institution from April 2019 to April 2021. First, we evaluated the cervical ICA course in these patients through cerebral angiography and classified the courses into type S, type I, and type Z. Then, we focused on the most frequently encountered type-S cervical ICA to investigate the forging effect of the GC tip into an S-shape. We evaluated the lateral view of the carotid angiograms to examine whether the catheter tip reached the foramen magnum (FM) without interrupting ICA blood flow.The effects of age, sex, side, a history of hypertension and smoking, and an S-shape modification of the GC tip on the outcome of GC placement were analyzed.Results: A total of 67 patients were included in this study. The tip of the GC was placed at the FM in 27 cases. Among these factors, only the S-shape modification was significantly associated with whether the GC could be placed at the level of the FM (p <0.0001). Conclusion:By forging the tip of the GC into an S-shape, the GC can be safely advanced to the distal part of the cervical ICA, which may contribute to the improved maneuverability of microcatheters.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Effectiveness of S-Shaping of the Tip of the FUBUKI Guiding Catheter to Match the Shape of the Cervical Internal Carotid Artery in Anterior Circulation Cerebral Aneurysm Embolization

Indo,

Oya,

Yoshida

et al. 2024

JNET

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“…В настоящее время используются различные подходы и эндоваскулярные технические приемы для решения проблемы доступа к церебральным сосудам при наличии грубых деформаций ветвей дуги аорты и брахиоцефальных артерий: специальная укладка больного на операционном столе [11]; использование специально разработанных проводниковых катетеров [10]; применение баллон-катетерной техники [7,21]; установка дополнительных стентов в области перегиба [12]. Эти методики позволяют решить проблему доступа в определенных случаях, но не всегда.…”

Section: Discussionunclassified

“…Одна из основных причин этого -наличие грубых деформаций брахиоцефальных артерий. Известные в настоящее время методы преодоления грубых перегибов артерий при выполнении эндоваскулярных вмешательств имеют существенные недостатки, ограничивающие их широкое применение [5][6][7][8][9][10][11][12].…”

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Resection and correction of the common carotid artery to enable an endovascular approach for treatment of a giant ICA aneurysm (a case report and literature review)

et al. 2018

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The article reports a clinical case of endovascular treatment of a female patient with a giant aneurysm of the cavernous internal carotid artery complicated by gross ipsilateral bending of the proximal third of the common carotid artery. To ensure an adequate endovascular approach to the aneurysm, open repair of the common carotid artery and elimination of its bending were performed at the first stage. This enabled successful placement of a flow-diverting stent into the internal carotid artery at the aneurysm level at the second stage, resulting in good technical and clinical outcomes. We discuss the technical aspects of performed interventions and the opportunity of using this approach in patients who need endovascular interventions that are complicated by anatomical-morphological changes in the brachiocephalic arteries.

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Comparison of treatment outcomes and complications of coil embolization in elderly and very elderly patients with cerebral aneurysms: a propensity score matching analysis

Choi,

Kim,

Huh

et al. 2023

Acta Neurochir

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Use of Simple Neck Extension to Improve Guiding Catheter Accessibility in Tortuous Cervical Internal Carotid Artery for Endovascular Embolization of Intracranial Aneurysm: A Technical Note

Cited by 9 publications

References 15 publications

Effectiveness of S-Shaping of the Tip of the FUBUKI Guiding Catheter to Match the Shape of the Cervical Internal Carotid Artery in Anterior Circulation Cerebral Aneurysm Embolization

Effectiveness of S-Shaping of the Tip of the FUBUKI Guiding Catheter to Match the Shape of the Cervical Internal Carotid Artery in Anterior Circulation Cerebral Aneurysm Embolization

Resection and correction of the common carotid artery to enable an endovascular approach for treatment of a giant ICA aneurysm (a case report and literature review)

Comparison of treatment outcomes and complications of coil embolization in elderly and very elderly patients with cerebral aneurysms: a propensity score matching analysis

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