Endovascular treatment of wide-neck intracranial aneurysms using a microcatheter protective technique: Results and outcomes in 75 aneurysms

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Abstract

BACKGROUND AND PURPOSE: The microcatheter protective technique positions an additional microcatheter in the parent or side-branching artery to protect it during coil embolization. The purpose of this study was to describe this method and to evaluate its efficacy and safety as an alternative to a multiple-microcatheter or balloon- or stent-assisted technique for wide-neck aneurysms. MATERIALS AND METHODS: A retrospective review of 74 patients (43 women; mean age, 59.6 years) with 75 wide-neck aneurysms treated with the microcatheter protective technique between January 2003 and April 2010 was performed. Immediate postembolization angiograms were evaluated by using a conventional angiographic scale, and clinical evaluation was performed by using the GOS. Clinical and imaging follow-up were available in 57 (76%) patients, with a mean of 14.7 months. RESULTS: Postembolization angiograms demonstrated total occlusion in 45 of 75 (60%) aneurysms, a neck remnant in 17 (22.7%), and body filling in 13 (17.3%). The technique-related complication rate was 17.4% (13/75), and the procedural-related morbidity rate was 1.3% (1/74). All patients, except 3 complicated cases with a GOS of <4, had a GOS of 5 at the end of the study period. Of the 57 aneurysms with follow-up, recanalization developed in 5 (8.8%) aneurysms, and 3 (5.3%) cases of major recanalization were re-treated endovascularly. CONCLUSIONS: The microcatheter protective technique is feasible and safe for coil embolization of wide-neck aneurysms, especially in cases that are not suitable for multiple catheter or balloon- or stent-assisted techniques. Copyright © 2011 by the American Society of Neuroradiology.

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Lee, J. Y., Seo, J. H., Cho, Y. D., Kang, H. S., & Han, M. H. (2011). Endovascular treatment of wide-neck intracranial aneurysms using a microcatheter protective technique: Results and outcomes in 75 aneurysms. American Journal of Neuroradiology, 32(5), 917–922. https://doi.org/10.3174/ajnr.A2411

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