Journal: Clinical Neuroradiology

Article Title: When Two Is Better than One

doi: 10.1007/s00062-021-01053-x

Figure Lengend Snippet: Female patient with an incidental right supraophthalmic internal carotid artery aneurysm. a Planning 3D-rotational angiogram demonstrated the wide-necked aneurysm on the posterior ICA wall with an acute angle between the aneurysm neck and the parent artery creating a ledge. b A Synchro 0.014in. microwire ( white dashed arrow ) was navigated across the aneurysm; however, due to the off-set between the 0.027in. microcatheter and the microwire the tip of the microcatheter ( black arrow ) was stuck on the ledge ( white arrow ) between the aneurysm neck and the parent artery preventing to be advanced distally. c , d An X‑pedion 0.010in. (Medtronic, Minneapolis, MN, USA) microwire ( black dashed arrow ) was then introduced into the Phenom 0.027in. parallel to the Synchro 0.014in. and provided the necessary support for the microcatheter to be advanced past the aneurysm and positioned distally. e , f A 4.75 × 18 mm Pipeline Flex embolization device (Medtronic, Minneapolis, MN, USA) was subsequently deployed. The cone beam CT demonstrated a good wall apposition

Article Snippet: This technique has been reported in neurointerventions for vertebral artery origin stenting, or coil embolization of posterior circulation aneurysms in patients with proximal vessel tortuosity.

Techniques:

Journal: Clinical Neuroradiology

Article Title: When Two Is Better than One

doi: 10.1007/s00062-021-01053-x

Figure Lengend Snippet: Female patient with a family history of aneurysmal subarachnoid hemorrhage and incidental left paraophthalmic internal carotid artery. a 3D angiogram demonstrates the wide-necked aneurysm just distal to the origin of the ophthalmic artery. b Attempts to navigate a Marksman microcatheter over a Synchro 0.014in. microwire positioned in the left M2 were unsuccessful with the catheter tip being caught on the ophthalmic artery origin ( white arrow ). Note, a second microcatheter with a wire ( black arrow ) is being advanced into the aneurysm which was later used for coiling. c Adding an X‑pedion 0.010in microwire ( black dashed arrow ) within the Marksman microcatheter, which was advanced similarly into the left M2, provided the necessary support for the microcatheter to traverse across the ophthalmic segment for distal positioning. d – f A 4.75 × 18 mm Pipeline Flex embolization device was subsequently deployed and the aneurysm was coiled

Article Snippet: This technique has been reported in neurointerventions for vertebral artery origin stenting, or coil embolization of posterior circulation aneurysms in patients with proximal vessel tortuosity.

Techniques: