Journal: Radiology Case Reports

Article Title: Super-Selective Embolization Using Flow-Directed Microcatheter and 0.010-inch Microwire for Type II Endoleak Following Thoracic Endovascular Aortic Repair: A Three-Case Report

doi: 10.1016/j.radcr.2025.09.040

Figure Lengend Snippet: Embolization procedure in Case 1. Endovascular embolization of a type II Endoleak (T2EL) in case 1. A 4-Fr sheath was inserted into the left brachial artery. (A) Digital subtraction angiography (DSA) identifying the feeder vessel as the aneurysmal sac arising from the costocervical artery, deep cervical artery, and responsible feeder vessel. (B) A triple coaxial system comprising 2.85/2.9-Fr (Carry Leon High-flow, UTM, Aichi, Japan) and 1.5/1.7/1.9-Fr (Carry Leon 2 marker, UTM, Aichi, Japan) microcatheters, and a 0.014-inch (Meister, Asahi Intecc, Aichi, Japan) guidewire was inserted and advanced toward the aneurysm. However, the 1.5/1.9-Fr microcatheter could not be advanced distally beyond the proximal segment of the deep cervical artery (white arrow). (C) Microcatheter system was changed to a 6.5-Fr guiding sheath. Using a VTA catheter and a 0.010-inch (CHIKAI 10, Asahi Intecc, Aichi, Japan) guidewire, a 1.5/2.4-Fr (DeFrictor BULL, Medicos Hirata, Tokyo, Japan) flow-directed microcatheter was inserted, successfully advancing from the deep cervical artery into the intercostal artery and finally reaching the aneurysm sac. (D, E) DSA demonstrated an aneurysm sac measuring approximately 18 mm in diameter. Embolization was performed using approximately 1.5 mL NBCA mixed with lipiodol (33%). (F) Post-embolization DSA confirmed elimination of the endoleak.

Article Snippet: The right thyrocervical artery was similarly catheterized using a 4-Fr RIM catheter and a 1.5/2.4-Fr (DeFrictor BULL; Medicos Hirata, Tokyo, Japan) microcatheter, which also reached the aneurysm sac ( C).

Techniques: Marker

Journal: Radiology Case Reports

Article Title: Super-Selective Embolization Using Flow-Directed Microcatheter and 0.010-inch Microwire for Type II Endoleak Following Thoracic Endovascular Aortic Repair: A Three-Case Report

doi: 10.1016/j.radcr.2025.09.040

Figure Lengend Snippet: Embolization procedure in Case 2. Both brachial arteries were punctured, with a 5.3-Fr guiding sheath inserted on the left side and a 4-Fr sheath on the right side. (A) Left thyrocervical artery is selected using a 4Fr VTA catheter. Digital subtraction angiography (DSA) revealed an aneurysmal sac via the intercostal artery. (B) A 1.5/2.4-Fr (DeFrictor BULL, Medicos Hirata, Tokyo, Japan) microcatheter was navigated through the tortuous vessels using 0.010-inch (CHIKAI 10 and CHIKAI X010, Asahi Intecc, Aichi, Japan) guidewires, successfully reaching the aneurysm sac (white arrow). (C) Right thyrocervical artery was similarly accessed using a 4-Fr RIM catheter and a 1.5/2.4-Fr (DeFrictor BULL, Medicos Hirata, Tokyo, Japan) microcatheter, which also reached the sac (white arrow). (D) Six 0.012-inch (i-ED, Kaneka Medix. Corporation, Osaka, Japan) coils were placed in the aneurysm sac using the right microcatheter system. (E) Three additional coils were placed in the intercostal artery. (F) On the left side, a mixture of N-butyl cyanoacrylate (NBCA) and lipiodol (33%) was injected to fill the sac. (G) NBCA embolization was performed on the right side following a lidocaine test at the feeder vessel, confirming the absence of neurological symptoms. (H) DSA confirms successful embolization of both the feeding arteries and the aneurysmal sac.

Article Snippet: The right thyrocervical artery was similarly catheterized using a 4-Fr RIM catheter and a 1.5/2.4-Fr (DeFrictor BULL; Medicos Hirata, Tokyo, Japan) microcatheter, which also reached the aneurysm sac ( C).

Techniques: Injection

Journal: Radiology Case Reports

Article Title: Super-Selective Embolization Using Flow-Directed Microcatheter and 0.010-inch Microwire for Type II Endoleak Following Thoracic Endovascular Aortic Repair: A Three-Case Report

doi: 10.1016/j.radcr.2025.09.040

Figure Lengend Snippet: Embolization procedure in Case 3. A 5.3-Fr guiding sheath was introduced via the left brachial artery. (A) A 4-Fr RIM catheter is inserted into the left costocervical artery, and digital subtraction angiography (DSA) performed using a 2.85/2.9-Fr microcatheter demonstrated blood flow into the aneurysm sac (white arrow) through the bronchial artery (black arrow). (B) A 1.5/2.4-Fr (DeFrictor BULL, Medicos Hirata, Tokyo, Japan) microcatheter was advanced close to the aneurysm sac using a 0.010-inch (CHIKAI 10 and CHIKAI X010, Asahi Intecc, Aichi, Japan) guidewire, with the procedure performed at a right anterior oblique (RAO) working angle of 23°. (C) Severe vessel tortuosity resulted in narrowing of the microcatheter lumen (white arrow), complicating reintroduction of the microwire. (D, E) N-butyl cyanoacrylate (NBCA) was mixed with lipiodol (in a 1:2 ratio, approximately 3.6 mL) and injected to fill the sac and feeder vessels. (F) Post-procedure DSA confirmed complete exclusion of the endoleak, indicating successful embolization.

Article Snippet: The right thyrocervical artery was similarly catheterized using a 4-Fr RIM catheter and a 1.5/2.4-Fr (DeFrictor BULL; Medicos Hirata, Tokyo, Japan) microcatheter, which also reached the aneurysm sac ( C).

Techniques: Injection

Journal: Interventional Neuroradiology

Article Title: Novel solution for luminal access loss into the double-layered LVIS Blue™ construct

doi: 10.1177/1591019917714462

Figure Lengend Snippet: While re-advancing the Headway 21 microcatheter over the delivery system of the second stent, the proximal end of the whole LB stent construct retracted into the aneurysm Thus distal luminal access was lost.

Article Snippet: 2 A Headway 21 (MicroVention, Inc., Tustin, CA, USA) microcatheter was exchanged for the Phenom microcatheter.

Techniques: Construct

Journal: Interventional Neuroradiology

Article Title: Novel solution for luminal access loss into the double-layered LVIS Blue™ construct

doi: 10.1177/1591019917714462

Figure Lengend Snippet: In order to traverse double layered LB construct we used Duo 167 microcatheter over Syncro 2 microwire.

Article Snippet: 2 A Headway 21 (MicroVention, Inc., Tustin, CA, USA) microcatheter was exchanged for the Phenom microcatheter.

Techniques: Construct