Optimal Guiding Catheter Length for Endovascular Coiling of Intracranial Aneurysms in Anterior Circulation in Era of Flourishing Distal Access System

PurposeTo determine the minimum required guiding catheter length for embolization of various intracranial aneurysms in anterior circulation and to analyze the effect of various patient factors on the required catheter length and potential interaction with its stability.Materials and MethodsFrom December 2016 to March 2017, 90 patients with 93 anterior circulation aneurysms were enrolled. Three types of guiding catheters (Envoy, Envoy DA, and Envoy DA XB; Codman Neurovascular, Raynham, MA, USA) were used. We measured the in-the-body length of the catheter and checked the catheter tip location in the carotid artery. We analyzed factors affecting the in-the-body length and stability of the guiding catheter system.ResultsThe average (±standard deviation) in-the-body length of the catheter was 84.2±5.9 cm. The length was significantly longer in men (89.1±5.6 vs. 82.1±4.6 cm, P