| Microcatheter neck bridging and incorporated branch vessel protection for coil embolization of a wide-neck ruptured aneurysm: technical case report. | |
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MedLine Citation:
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PMID: 21206323 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND IMPORTANCE: A novel technique in which microcatheter neck bridging of a ruptured wide-neck posterior communicating artery aneurysm was performed by intra-aneurysmal catheter navigation into a fetal configuration posterior cerebral artery (PCA) branch vessel arising from the sac. CLINICAL PRESENTATION: An 88-year-old woman with a Hunt and Hess grade 1 and Fisher grade 4 subarachnoid hemorrhage was identified as having a wide-neck posterior communicating artery aneurysm and an isolated fetal configuration PCA with origins from the aneurysm sac. Delivery of a bare platinum Guglielmi detachable coil within the aneurysm lumen resulted in persistent coil prolapse into the parent vessel with occlusion of the incorporated vital PCA origin. A microcatheter was then navigated through the aneurysm lumen and into the fetal configuration PCA. This was retained within the PCA with resultant aneurysm neck narrowing and branch vessel protection. A second microcatheter was placed in the aneurysm lumen for coil delivery. Complete aneurysm occlusion with patency of the PCA without coil loop prolapse into the parent vessel was achieved. CONCLUSION: The presence of normal branch vessels arising from the dome is a limitation for endovascular techniques. To the best of our knowledge, no prior description of a dual-microcatheter technique with selective catheter placement within an important intra-aneurysmal branch vessel has been published. The vital branch vessel was protected and the wide-neck aneurysm completely occluded. Novel placement of microcatheters further expands the range of complex configuration aneurysms amenable to endovascular coiling. |
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Authors:
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Ajeet Gordhan |
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Publication Detail:
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Type: Case Reports; Journal Article; Technical Report |
Journal Detail:
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Title: Neurosurgery Volume: 68 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-04-11 Completed Date: 2011-06-21 Revised Date: 2011-08-25 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 40-3; discussion 43-4 Citation Subset: IM |
Affiliation:
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St. Joseph Medical Center, Department of Neurointerventional Radiology, Bloomington, Illinois 61701, USA. gordhana@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged, 80 and over Aneurysm, Ruptured / complications, surgery* Angiography, Digital Subtraction / methods Embolization, Therapeutic / instrumentation*, methods* Endovascular Procedures / methods Female Humans Intracranial Aneurysm / complications, surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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