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Low-angled microcatheter approach for coil embolization of the anterior choroidal artery aneurysm

Neuroradiology volume 59, pages 1053–1056 (2017)Cite this article

Abstract

Purpose

Thromboembolic complication is a serious concern following coil embolization for aneurysms involving the anterior choroidal artery (AChA). To minimize this complication and to improve packing density, we present a technical concept of coil embolization.

Methods

We attempted packing of the aneurysmal sac by lowering the microcatheter approach angle into an aneurysm to secure AChA origin as well as to improve coil packing density of the aneurysm. This technical concept involves approaching the aneurysm sac with an adjusted shaping of the microcatheter tip to achieve the effect which was not obtained when the microcatheter approach angle into the aneurysm sac was high (≥90°). We evaluated immediate angiographic outcome by the Raymond classification, coil packing density, and follow-up results (modified Rankin Scale (mRS) and recurrence) in seven aneurysms involving AChA in six patients.

Results

We achieved immediate angiographic outcome of the Raymond classes I or II with 31% mean packing density. The AChA origin was preserved without any procedure-related complication. There was neither clinical event (mRS = 0) nor aneurysm recurrence confirmed on the source image of magnetic resonance angiography during 6–9 months follow-up.

Conclusions

The technical concept of low-angled microcatheter approach can be useful to improve coil packing density and to secure AChA origin when AChA arises near the aneurysm.

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Fig. 1
Fig. 2

Abbreviations

AChA:

Anterior choroidal artery

MRS:

Modified Rankin scale

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Authors and Affiliations

  1. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea

    Jae Jon Sheen & Dae Chul Suh

Authors
  1. Jae Jon Sheen
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  2. Dae Chul Suh
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Corresponding author

Correspondence to Dae Chul Suh.

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No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Sheen, J.J., Suh, D.C. Low-angled microcatheter approach for coil embolization of the anterior choroidal artery aneurysm. Neuroradiology 59, 1053–1056 (2017). https://doi.org/10.1007/s00234-017-1879-y

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  • DOI: https://doi.org/10.1007/s00234-017-1879-y

Keywords

  • Aneurysm
  • Coil
  • Embolic
  • Technique