Loop microcatheter technique for coil embolization of paraclinoid aneurysms

2018 ◽  
Vol 160 (9) ◽  
pp. 1755-1760 ◽  
Author(s):  
Zhen Yu Jia ◽  
Yun Sun Song ◽  
Jae Jon Sheen ◽  
Joong Goo Kim ◽  
Chae Woon Lee ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Paraclinoid Aneurysms

DELAYED VISUAL DEFICITS AND MONOCULAR BLINDNESS AFTER ENDOVASCULAR TREATMENT OF LARGE AND GIANT PARAOPHTHALMIC ANEURYSMS

Neurosurgery ◽  
2008 ◽  
Vol 63 (3) ◽  
pp. 469-475 ◽  
Author(s):  
Raymond D. Turner ◽  
James V. Byrne ◽  
Michael E. Kelly ◽  
Aristotelis P. Mitsos ◽  
Vivek Gonugunta ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Coil Embolization ◽  
Case Series ◽  
Mass Effect ◽  
Endovascular Coiling ◽  
Visual Deterioration ◽  
Paraclinoid Aneurysms ◽  
Bare Platinum Coils ◽  
Platinum Coils

ABSTRACT OBJECTIVE Paraophthalmic aneurysms may exert mass effect on the optic apparatus. Although surgical clipping and endovascular coiling of these aneurysms can be complicated by immediate postoperative visual deterioration, endovascular coil embolization has the unique risk of visual complications later (>24 h) in the perioperative period. METHODS Six patients with a delayed onset of vision loss after technically successful coil embolization of paraophthalmic region aneurysms were identified. All available clinical, angiographic, and cross sectional imaging for these patients, in addition to histopathological data, were reviewed. RESULTS Six patients who underwent endovascular treatment of paraclinoid aneurysms at our institutions developed delayed postoperative visual decline. Four were treated with combination hydrogel-coated and bare platinum coils, one with hydrogel-coated coils, and one with bare platinum coils. Three patients presented with some degree of visual impairment caused by their aneurysms. Catheter angiography performed after the visual decline revealed no etiology in any of the cases. Magnetic resonance imaging was performed in all patients and was unremarkable in two. At follow-up, two had improved, three remained unchanged, and one patient died before any follow-up assessment of her vision. CONCLUSION Both acute and delayed visual disturbances can present after the endovascular treatment of carotid artery paraophthalmic aneurysms. Delayed visual deterioration can be observed up to 35 days after embolization. Although the cause is still undefined, it is likely that the more delayed visual deterioration can be attributed to progression of mass effect and/or perianeurysmal inflammatory change. Our case series raises the possibility that this phenomenon may be more likely with HydroCoil (HydroCoil Embolic System; MicroVention, Aliso Viejo, CA). This possibility should be taken into account by neurointerventionists when selecting a coil type to treat large paraophthalmic aneurysms.

scholarly journals Comparison of Pipeline Embolization and Coil Embolization for the Treatment of Large Unruptured Paraclinoid Aneurysms

2021 ◽  
Author(s):  
Ryotaro SUZUKI ◽  
Tomoji TAKIGAWA ◽  
Yasuhiko NARIAI ◽  
Akio HYODO ◽  
Kensuke SUZUKI
Keyword(s):  
Coil Embolization ◽  
Paraclinoid Aneurysms

scholarly journals Microcatheter Stabilization Technique Using Partially Inflated Balloon for Coil Embolization of Paraclinoid Aneurysms

2021 ◽  
Author(s):  
Yunsun Song ◽  
Boseong Kwon ◽  
Abdulrahman Hamad Al-abdulwahhab ◽  
Ricky Gusanto Kurniawan ◽  
Dae Chul Suh
Keyword(s):  
Coil Embolization ◽  
Internal Carotid ◽  
Complete Occlusion ◽  
Inflated Balloon ◽  
Aneurysm Neck ◽  
Paraclinoid Aneurysms ◽  
Hemorrhagic Events ◽  
Benign Nature ◽  
Stabilization Technique

Purpose: Coil embolization of paraclinoid aneurysms should be simple, safe, and effective considering the benign nature of the aneurysm. Here, we present a microcatheter stabilization technique using a partially inflated balloon for the treatment of paraclinoid aneurysms.Materials and Methods: This retrospective study included 58 patients who underwent balloon-assisted coiling (BAC) for unruptured paraclinoid aneurysms at a tertiary neuro-intervention center between January 2019 and March 2020. We applied a technique to stabilize the microcatheter’s position using the modified BAC technique in paraclinoid aneurysms showing various projections around the ophthalmic curve of the internal carotid artery. The basic concept of the technique is to place a partially inflated balloon just distal to the aneurysm neck and support the distal curve of the microcatheter using the proximal bottom of the balloon. Immediate radiological outcomes were analyzed, and clinical outcomes were evaluated with modified Rankin Scale (mRS) scores.Results: The BAC was successfully performed in 51 of 58 patients (88%). We treated the remaining seven patients by switching to stent-assisted coiling. We obtained a 37% mean packing density resulting in favorable occlusion in all 58 aneurysms (complete occlusion in 35 and residual neck in 23). There were no intraprocedural thromboembolic or hemorrhagic events except one that revealed an asymptomatic infarction after the procedure (1.7%). Magnetic resonance angiography follow-up was performed in 37 patients at an average of 11.8 months, in which 11 minor recurrences (29.7%) were found. There was no major recurrence nor retreatment. The mRS score was 0 in all patients during a mean follow-up of 17.7 months (range, 12–25 months).Conclusion: The modified balloon-assisted coiling technique using a partially inflated balloon was safe and effective and could serve as an option for treating paraclinoid aneurysms.

scholarly journals Geometric classification of paraclinoid aneurysms for microcatheter selection in coil embolization

2019 ◽  
Author(s):  
Yeongu Chung ◽  
Jiwook Ryu ◽  
Eui Jong Kim ◽  
Sung Ho Lee ◽  
Seok Keun Choi
Keyword(s):  
Coil Embolization ◽  
Paraclinoid Aneurysms

Long-term follow-up of intra-aneurysmal coil embolization for unruptured paraclinoid aneurysms

2012 ◽  
Vol 34 (9) ◽  
pp. 864-870 ◽  
Author(s):  
Takatoshi Sorimachi ◽  
Yasushi Ito ◽  
Kenichi Morita ◽  
Yasushi Jimbo ◽  
Kazuhiko Nishino ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Paraclinoid Aneurysms ◽  
Long Term Follow Up

scholarly journals Clinical and Radiogical Outcomes of Endovascular Detachable Coil Embolization in Paraclinoid Aneurysms : A 10-Year Experience

2009 ◽  
Vol 45 (1) ◽  
pp. 5 ◽  
Author(s):  
Sung-Chul Jin ◽  
Do Hoon Kwon ◽  
Jae-Sung Ahn ◽  
Byung-Duk Kwun ◽  
Young Song ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Detachable Coil ◽  
Paraclinoid Aneurysms

Predictors of recurrence after stent-assisted coil embolization of paraclinoid aneurysms

2016 ◽  
Vol 33 ◽  
pp. 173-176 ◽  
Author(s):  
Nan Lv ◽  
Rui Zhao ◽  
Pengfei Yang ◽  
Yibin Fang ◽  
Qiang Li ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Predictors Of Recurrence ◽  
Paraclinoid Aneurysms

scholarly journals Outcome Analysis of the Flow Diversion with Pipeline Embolization Device for the Surgical Treatment of Unruptured Large and Giant Paraclinoid Carotid Aneurysms

2018 ◽  
Vol 73 (1) ◽  
pp. 16-22
Author(s):  
V. A. Byvaltsev ◽  
Y. T. Makhambetov ◽  
I. A. Stepanov ◽  
A. B. Kaliyev ◽  
A. K. Akshulakov
Keyword(s):  
Surgical Treatment ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Coil Embolization ◽  
Internal Carotid ◽  
Blood Stream ◽  
Neurologic Deficit ◽  
Outcome Analysis ◽  
Pipeline Embolization Device ◽  
Paraclinoid Aneurysms

Background: Both the high frequency of recurrence of large or giant paraclinoid aneurysms (PA) of the internal carotid artery and the occurrence of intra- and postoperative complications, leading to unsatisfactory results of surgical treatment of this group of patients, make the stated problem urgent. Flow-diverter embolization devices are actively used in many large international neurosurgical centers for the treatment of cerebral aneurysms of different morphology, size, and localization. Currently, there are very few reports on the effectiveness of the use of flow diverting stents in the surgical treatment of large and giant PA of the internal carotid artery. The results of these studies are controversial and largely contradictory. Aim: Outcome analysis of the use of Pipeline embolization device (PED) for the surgical treatment of large and giant carotid PA. Methods: The study enrolled 37 patients (25 women, 12 men; mean age 51.7±10.7 years) who were divided into those treated with the PED alone versus those treated with the PED and concurrent coil embolization. The average follow-up period was 19.7±3.8 months. Results: In 56.7% of cases, PA caused the development of an insignificant neurological deficit (Modified Rankin Scale 1−2). In 18.9% of patients, PA provoked a gross neurologic deficit (MRS 3−5). 24.3% of patients with PA did not have any clinical-neurological manifestations. After the surgery, neurologic status improved in 32.4% of patients, remained the same — in 45.9% of cases, and the degree of neurologic deficit increased in 21.6%. PED procedure was performed in 70.2% of patients. In 29.7% of cases, the dislocation of large or giant PA of the internal carotid artery from the systemic blood stream was performed using PED and concurrent coil embolization. At the indicated period of patient observation, complete occlusion of large and giant carotid PA was achieved in 75.6% of cases, almost complete and partial occlusion — in 24.3%. The incidence of thromboembolic and hemorrhagic complications was 10.8% and 8.1%, respectively. Mortality rate among patients was 2.7%. Conclusions: The use of PED is an effective method for occluding large or giant PA of the internal carotid artery. Nevertheless, this method of endovascular treatment of PA is associated with a high complication incidence.

scholarly journals Microcatheter Looping to Facilitate Aneurysm Selection in Coil Embolization of Paraclinoid Aneurysms

2015 ◽  
Vol 16 (4) ◽  
pp. 899 ◽  
Author(s):  
Young Dae Cho ◽  
Jong Kook Rhim ◽  
Jeong Jin Park ◽  
Jin Sue Jeon ◽  
Roh-Eul Yoo ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Paraclinoid Aneurysms
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