scholarly journals Balloon-Catheter Buddy Technique for Coiling of Very Small Aneurysm

2021 ◽  
Author(s):  
Vikas Bhatia ◽  
Bharat Hosur DM ◽  
Ajay Kumar MD ◽  
Keyword(s):  
Balloon Catheter ◽  
Small Aneurysms ◽  
Small Aneurysm

AbstractThe catheter movement and stability in coiling of very small aneurysms is challenging. We describe a technique for controlled catheter movement and successful coiling of a very small aneurysm.

Balloon-assisted coil embolization of small intracranial aneurysms

2014 ◽  
Vol 37 (v1supplement) ◽  
pp. 1 ◽  
Author(s):  
Peng Roc Chen
Keyword(s):  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Case Examples ◽  
Link Type ◽  
Aneurysm Embolization ◽  
Small Aneurysms ◽  
Small Aneurysm

It is generally considered difficult and risky to treat a small aneurysm (less than 4 mm) by use of coil embolization. The main issues are related to the following factors: frequently broad-based aneurysm with shallow dome, complex in shape, difficult to maintain microcatheter stability in an aneurysm, difficult to achieve complete coil packing, and higher risk of intra-procedure rupture hemorrhage. However, routine use of balloon-assisted coiling technique will enable us to achieve successful aneurysm embolization with safety. This video demonstrates some key nuances in the balloon-assisted coil embolization of small aneurysms via three case examples.The video can be found here: http://youtu.be/E1il3oPnUD8.

scholarly journals Use of a new soft and long coil reduces the number of coils to embolize a small aneurysm

2015 ◽  
Vol 21 (2) ◽  
pp. 161-166 ◽  
Author(s):  
Akiyo Sadato ◽  
Motoharu Hayakawa ◽  
Kazuhide Adachi ◽  
Yoko Kato ◽  
Yuichi Hirose
Keyword(s):  
Cerebral Aneurysm ◽  
Unit Volume ◽  
Matched Control ◽  
High Volume ◽  
Aneurysm Volume ◽  
Small Aneurysms ◽  
Small Aneurysm

Background In embolizing a cerebral aneurysm, achievement of a high-volume embolization ratio (VER: volume of inserted coils / aneurysm volume) is important because it may prevent coil compaction and recanalization. The goal of the study is to examine whether use of softer and longer coils gives an adequate VER with fewer coils, particularly for small aneurysms. Methods Aneurysm volumes, VERs, and numbers of inserted coils were investigated in 23 cases of small aneurysms embolized using Infini coils, a long soft coil with a primary diameter of 0.010 inches (Infini group). An aneurysm volume- and VER-matched control (non-Infini) group of 59 cases was selected from patients treated at our facility. Data were also compared between subgroups of patients ( n = 18 and n = 34 in the Infini and non-Infini groups, respectively) who were not treated with thicker coils with primary diameters of 0.0135–0.015 inches (18-type coils), since these coils affect the number of coils by increasing VER rapidly. Results Average aneurysm volumes and VERs did not differ significantly between the Infini and non-Infini groups. Significantly fewer coils were used per 0.1 ml aneurysm volume in the Infini group (4.08 coils in average) compared with the non-Infini group (5.67) ( p < 0.001). In the non-18-type subgroups, the number of coils used remained significantly smaller in the Infini group (4.49) compared with the non-Infini group (6.72), ( p < 0.001). Conclusion To achieve VER ≥20%, use of Infini coils significantly decreased the number of coils required per unit volume of a small aneurysm.

scholarly journals Efficacy of the proximal balloon flow control method for endovascular coil embolisation as a novel adjunctive technique: A retrospective analysis

2018 ◽  
Vol 24 (4) ◽  
pp. 375-378 ◽  
Author(s):  
Tomotaka Ohshima ◽  
Shigeru Miyachi ◽  
Naoki Matsuo ◽  
Reo Kawaguchi ◽  
Aichi Niwa ◽  
...  
Keyword(s):  
Flow Control ◽  
Internal Carotid ◽  
Control Method ◽  
Balloon Catheter ◽  
Endovascular Coiling ◽  
Coil Embolisation ◽  
Anterior Circulation ◽  
Small Aneurysms ◽  
Anterior Circulation Aneurysms ◽  
Guiding Catheter

Background and purpose In our previous study, we established the utility of 8-F balloon guide catheters for anterior circulation aneurysms. This study aims to assess the efficacy of the proximal flow control method using 8-F balloon guide catheters for coil deployment into the aneurysms as a novel adjunctive technique for aneurysmal coil embolisation along with local balloon neck remodeling, stent assist and double catheter techniques. Materials and methods We retrospectively analysed patients who underwent endovascular coiling of anterior circulation aneurysms between August 2013 and December 2017. Results Of 206 patients enrolled in this study, the balloon of the guiding catheter was inflated to assist coil deployment in 43 patients (20.9%). In addition, the proximal flow control method found utility in cases with small aneurysms and relatively narrow-necked internal carotid artery. We observed no intraprocedural complications in this study. Conclusion This technique enabled secure coil deployment without navigating another microcatheter or balloon catheter around the aneurysms.

scholarly journals Double microcatheter technique for coil embolization of small aneurysms with unfavorable configurations: A comparative study of the aneurysms that are ≤3 mm or >3 mm

2016 ◽  
Vol 22 (2) ◽  
pp. 158-164 ◽  
Author(s):  
Long Yin ◽  
Ming Wei ◽  
Hecheng Ren
Keyword(s):  
Coil Embolization ◽  
Endovascular Coiling ◽  
Significant Treatment ◽  
Branch Vessel ◽  
Technical Details ◽  
The Mean ◽  
Wide Neck ◽  
Small Aneurysms ◽  
Small Aneurysm

Introduction The endovascular coiling of small ruptured aneurysms with difficult geometries presents a significant treatment challenge. We report our initial experience and the technical details of dual microcatheter coil embolizations that were applied in these difficult lesions. Method and results Eighty-five small aneurysms (<7 mm) that exhibited difficult configurations, such as a wide neck or an important branch vessel arising from the fundus, were successfully treated using a dual microcatheter technique. The packing attenuation, adverse events during the procedures, and angiographic occlusions from 21 very small aneurysm (≤3 mm) were recorded and compared with our coiling results of 64 small aneurysms (>3 mm, <7 mm). There were no significant differences in intraprocedural ruptures or procedure-related thromboembolisms between the two groups. At the last post-procedure clinical follow-up, a good clinical outcome (an modified Rankin Scale (mRS) of 0–2) was observed in 18 of the patients (85.7%). The recanalization rates at follow-up were significantly lower in the very small aneurysm group compared to the small aneurysm group ( p < 0.05) and the mean packing density in the very small aneurysm group was significantly higher compared to the small aneurysm group (35.2% vs 24.8%, p < 0.05). Conclusion The dual technique was feasible, safe, and effective for coil embolization of aneurysms with difficult configurations and, in particular, it provided an alternative option for treating very small aneurysms.

Outcome after subarachnoid hemorrhage from a very small aneurysm: a case-control series

2004 ◽  
Vol 100 (4) ◽  
pp. 623-625 ◽  
Author(s):  
Christopher L. Taylor ◽  
Debra Steele ◽  
Thomas A. Kopitnik ◽  
Duke S. Samson ◽  
Phillip D. Purdy
Keyword(s):  
Case Control ◽  
Control Analysis ◽  
Control Series ◽  
Content Type ◽  
Fisher Grade ◽  
Grade 3 ◽  
Case Control Analysis ◽  
Small Aneurysms ◽  
Small Aneurysm ◽  
Fine Print

Object. A case-control analysis of patients with SAH was performed to compare risk factors and outcomes at 6 months posthemorrhage in patients with a very small aneurysm compared with those with a larger aneurysm. Methods. All patients with SAH who were treated between January 1998 and December 1999 were studied. A very small aneurysm was defined as “equal to or less than 5 mm in diameter.” Clinical data and treatment summaries were maintained in an electronic database. The Glasgow Outcome Scale (GOS) score was determined by an independent registrar. One hundred twenty-seven patients were treated. A very small aneurysm was the cause of SAH in 42 patients (33%), whereas 85 (67%) had aneurysms larger than 5 mm (mean diameter 11 mm). There were no differences in demographic variables or medical comorbidities between the two groups. Thick SAH (Fisher Grade 3 or 4) was more common in patients with a very small aneurysm than in those with a larger aneurysm (p = 0.028). One hundred eight patients underwent microsurgery (85%), 15 underwent coil embolization (12%), and four (3%) required both procedures. Vasospasm occurred in nine patients (21%) with very small aneurysms compared with 14 (16%) with larger aneurysms (p = 0.62). Shunt-dependent hydrocephalus occurred in nine patients (21%) with very small aneurysms and in 19 (22%) with larger aneurysms (p = 1). The mean GOS score for both groups was 4 (moderately disabled) at 6 months. Conclusions. Small aneurysms produce thick SAH more often than larger aneurysms. There is no difference in outcome after SAH between patients with a very small aneurysm and those with a larger aneurysm.

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