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A novel technique for stent-assisted coil embolization of intracranial aneurysms: The wireless trans-cell approach.
- Source :
-
Asian Journal of Neurosurgery . Oct-Dec2019, Vol. 14 Issue 4, p1122-1125. 4p. - Publication Year :
- 2019
-
Abstract
- Background: When inserting coils under stent deployment, a jailed microcatheter technique is typically applied as a first line approach. However, the trans cell approach might be required to achieve satisfactory complete occlusion. The trans cell approach occasionally ends in failure because the catheter cannot safely follow a proceeding guidewire into the aneurysm. Here, we report the new wireless trans cell approach (WTA), which allows feasible and safe catheter navigation through the stent strut into the aneurysm, without a proceeding guidewire. Methods: A straight tip microcatheter was used, and the tip was shaped as a very small bend of approximately 45°. The side aspect of the catheter tip exhibited a right angled edge, while the front aspect showed a round curve in the advancing direction. We compared the 45° microcatheter with a straight tip microcatheter using a silicon vascular model and then applied the WTA in a case of an unruptured basilar apex aneurysm. Results: Catheter navigation through the stent strut was smoother with the WTA than the conventional wire assisted approach. Our case of a basilar apex aneurysm was successfully treated with the dual catheter technique, which involved a jailed catheter and navigation using the WTA. After stent deployment from the right posterior cerebral artery to the basilar artery through the 45° microcatheter, the WTA was applied using the same catheter. No stress was detected during catheter navigation through the stent strut into the aneurysm. Conclusions: The WTA is associated with smoother catheter navigation compared with the conventional wire assisted approach in cases of a terminal type aneurysm. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 17935482
- Volume :
- 14
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Asian Journal of Neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 139871646
- Full Text :
- https://doi.org/10.4103/ajns.AJNS_163_19