When Two Is Better than One

Dobrocky, Tomas; Lee, Hubert; Nicholson, Patrick; Agid, Ronit; Lynch, Jeremy; Swaminathan, Saravana Kumar; Krings, Timo; Radovanović, Ivan; Pereira, Vítor Mendes

doi:10.1007/s00062-021-01053-x

Cited by 3 publications

(1 citation statement)

References 18 publications

(18 reference statements)

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“…To avoid this, the “buddy-wire technique” has been reported, whereby the catheter is guided along two guidewires. [ 3 ] In the present case, a 0.010-inch guidewire was used along with a 0.014-inch guidewire during the catheter exchange to Phenom 27. A larger-diameter steerable microcatheter beforehand might allow catheter exchange with a larger-diameter guidewire.…”

Section: Discussionmentioning

confidence: 99%

Steerable microcatheter for distal access of a giant cavernous carotid artery aneurysm during treatment with Pipeline Embolization Device: A case report and review of the literature

Inoue,

Fujita,

Kurihara

et al. 2024

Surgical Neurology International

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Background: In the treatment of giant cerebral aneurysms with flow-diverting stents, access to the distal parent artery is critical but occasionally challenging. This article provides our experience with a novel steerable microcatheter in such a situation, as well as a review of the literature. Case Description: A 73-year-old woman presented with right ptosis and external ophthalmoplegia. Magnetic resonance angiography revealed a giant right cavernous internal carotid artery aneurysm. Endovascular treatment was planned with flow diversion, but distal access was not possible using the standard technique. A 2.4-Fr steerable microcatheter, Leonis Mova Selective, was implemented, and by bending the catheter tip toward the distal parent artery, a guidewire could be guided distally. After the catheter exchange, two flow-diverting stents were deployed successfully. Conclusion: Steerable microcatheters may provide an option in treatment with flow-diverting stents for giant cerebral aneurysms where access to the distal parent artery is compromised.

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Section: Discussionmentioning

confidence: 99%

Steerable microcatheter for distal access of a giant cavernous carotid artery aneurysm during treatment with Pipeline Embolization Device: A case report and review of the literature

Inoue,

Fujita,

Kurihara

et al. 2024

Surgical Neurology International

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The Aristotle 18 and 24 microwires in neuroIntervention: Early experience at a single centre

Carraro do Nascimento,

de Villiers,

Dhillon

et al. 2023

Interv Neuroradiol

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Background Current neurointerventional procedures are expanding the use of large bore microcatheters, of up to 0.033” inner diameters, to accommodate intrasaccular flow disruptors or neck-bridging devices, including flow diverters. The use of large bore microwires may mitigate the ledge gap between wire and catheter, facilitate navigation and offer support in distal tortuous anatomy. We aim to report our early experience using the novel Aristotle (Scientia Vascular, West Valley City, UT) 18 and 24 microwires in neurovascular interventions. Methods We analysed neurointerventional procedures in which the Aristotle 18 and 24 microwires were used at a single centre. Prospectively collected data, from March 2022 to February 2023, including patient's clinical outcome (successful target vessel, aneurysm catheterisation, peri-procedural complications (thromboembolic, haemorrhagic, vessel dissection or perforation) were analysed. Results Overall, the use of Aristotle 18 and 24 microwires was recorded in 84 neurointerventional procedures during the study period, including endovascular aneurysm treatment (n = 30), endovascular thrombectomy (n = 46), dural venous sinus manometry/stent placement (n = 7), and extracranial carotid artery stent placement (n = 1). The Aristotle 18 microwire was used in conjunction with 0.021” microcatheters and the Aristotle 24 microwire with the 0.027 or 0.033” microcatheters. In all cases (100%), the target vessel or aneurysm was reached with the microwire, allowing seamless advancement of the selected microcatheters. No procedure related complications were recorded. Conclusions The use of the Aristotle 18 and 24 microwires in neurointerventional procedures is feasible and safe. The microwires provide reduced ledge gap, improved torquability, support and safety over standard 0.014” microwires.

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Buddy Catheter Technique: A Method of Guiding the Mo.Ma Ultra into a Left Common Carotid Artery That Branches off the Aortic Arch at a Steep Angle

Kamamoto

Takahashi

Inoue

et al. 2022

JNET

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Objective The Mo.Ma Ultra is an embolic protection device used in carotid artery stenting (CAS). In cases of left internal carotid artery stenosis (ICS) in which the common carotid artery (CCA) branches off the aortic arch at a steep angle, insertion of the Mo.Ma Ultra into the CCA is sometimes difficult. We introduce a “buddy catheter technique” that helps guide the Mo.Ma Ultra into the CCA, with an additional 4 Fr catheter into the external carotid artery. Case Presentation An 84-year-old man with left ICS whose CCA also branched off the aortic arch at a steep angle also underwent CAS. The “buddy catheter technique” was used, and the Mo.Ma Ultra was inserted smoothly. The buddy catheter technique displaces the left CCA upward. Displacement straightens the vessels anatomically, and the ledge effect can be prevented by aligning the course of the vessels with the wire. Nevertheless, this technique requires bilateral femoral puncture, and so, complications can occur. Conclusion The buddy catheter technique may be considered in cases in which the left CCA branches off the aortic arch at a steep angle.

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When Two Is Better than One

Cited by 3 publications

References 18 publications

Steerable microcatheter for distal access of a giant cavernous carotid artery aneurysm during treatment with Pipeline Embolization Device: A case report and review of the literature

Steerable microcatheter for distal access of a giant cavernous carotid artery aneurysm during treatment with Pipeline Embolization Device: A case report and review of the literature

The Aristotle 18 and 24 microwires in neuroIntervention: Early experience at a single centre

Buddy Catheter Technique: A Method of Guiding the Mo.Ma Ultra into a Left Common Carotid Artery That Branches off the Aortic Arch at a Steep Angle

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