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Endovascular Treatment of Intracranial Aneurysms Using a Microcatheter Protection

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Abstract

Purpose

Stent protective or balloon remodeling techniques have enabled coil embolization of complexly configured aneurysms. Still, the utility of such methods may be limited in some small-caliber and/or inherently tortuous lesions. The present study was conducted to examine the efficacy of microcatheter protection (MCP) when applied in these circumstances.

Methods

This retrospective review included 432 patients with 452 intracranial aneurysms subjected to MCP between April 2001 and January 2021. All available medical records and radiologic data were analyzed, focusing on strategic, safety, and efficacy aspects of the procedures.

Results

In a majority (255/452, 56.4%) of cases, MCP was applied throughout entire coiling procedures, as opposed to coil framing (137/452, 30.3%) or filling/finishing (60/452, 13.3%) only. Lesions of the middle cerebral artery (54.9%) predominated, followed by anterior (12.4%) and posterior (11.1%) communicating artery aneurysms. Stent protection was also used occasionally (46/452, 10.2%). Procedural morbidity was low (3/432, 0.7%), limited to symptomatic thromboembolism and procedural leakage, and there were no deaths. Occlusion was successfully achieved by MCP in 424 aneurysms (93.8%). During the follow-up period (mean, 43.4 ± 30.4 months), satisfactory occlusion was documented in 406 of 440 (92.3%) aneurysms.

Conclusion

MCP is feasible and safe for coil embolization of intracranial aneurysms, in conjunction with multicatheter, balloon, or stenting techniques. MCP may have merit in small-sized or tortuous lesions not amenable to balloon or stent usage, often eliminating the need for stenting altogether.

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Authors and Affiliations

  1. Department of Neurosurgery, Inha University Hospital, Incheon, Korea (Republic of)

    Jin Woo Bae

  2. Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (Republic of)

    Han San Oh, Kang Min Kim & Hyun-Seung Kang

  3. Department of Neurosurgery, Veterans Health Service Medical Center, Seoul, Korea (Republic of)

    Chang-eui Hong

  4. Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Korea (Republic of)

    Dong Hyun Yoo & Young Dae Cho

Authors
  1. Jin Woo Bae
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  2. Han San Oh
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  3. Chang-eui Hong
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  4. Kang Min Kim
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  6. Hyun-Seung Kang
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  7. Young Dae Cho
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Correspondence to Young Dae Cho.

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Conflict of interest

J.W. Bae, H.S. Oh, C.-e. Hong, K.M. Kim, D.H. Yoo, H.-S. Kang and Y.D. Cho declare that they have no competing interests.

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Bae, J.W., Oh, H.S., Hong, Ce. et al. Endovascular Treatment of Intracranial Aneurysms Using a Microcatheter Protection. Clin Neuroradiol 33, 653–659 (2023). https://doi.org/10.1007/s00062-022-01252-0

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  • DOI: https://doi.org/10.1007/s00062-022-01252-0

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