Small series supports balloon microcatheter use for coil delivery in intracranial aneurysms

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A study, published online first in the Journal of Neurointerventional Surgery has found that a single coaxial dual balloon microcatheter can be used to achieve coil placement and neck remodelling in selected oblong intracranial and cervical arterial aneurysms.

According to Bharathi D Jagadeesan (Department of Radiology, University of Minnesota, Minneapolis, USA) and colleagues, a small series of five patients, two with subarachnoid haemorrhage and three with unruptured aneurysm who had wide-necked oblong aneurysm (8–30mm maximum dimensions, 2–15mm neck width) were included in the study.

The Scepter C (4x10mm) or Scepter XC balloon (4x11mm) microcatheters (MicroVention) were used in coil embolisation of four of the aneurysms by “advancing the tip of the microcatheter […] into the aneurysm, inflating the balloon at the aneurysm neck, and placing the coils through the same microcatheter”.

The authors note that in the fifth patient, who had a giant aneurysm at the top side of the basilar artery, two Scepter XC microcatheters were placed. The authors describe this, saying they placed the microcatheters side by side and inflated them simultaneously at the neck of the aneurysm and report that “coil embolisation was then successfully performed through both Scepter XC microcatheters”.

In their conclusion, Jagadeesan et al say that, in the case of aneurysmal neck remodelling and coil embolisation, both can be achieved with a single coaxial dual lumen balloon microcatheter “in selected oblong intracranial and cervical arterial aneurysms”. In this series there were no reported aneurysm rupture, thromboembolic complications, occlusion of branch vessels near the aneurysm neck, or prolapse of coil loops into the parent vessel.

In an earlier study, published in the same journal in January 2013, Seby John et al reported their initial experience using the Scepter C balloon catheter. The authors say that using the Scepter C in endovascular treatment for post-haemorrhagic cerebral vasopasm (which “accounts for significant morbidity and mortality in subarachnoid haemorrhage patients”) is feasible when medical management fails.

 

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