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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(02): 384-386
DOI: 10.4103/ajns.AJNS_26_21
Case Report

Local balloon-assisted navigation of a microcatheter into an aneurysm during intracranial aneurysmal coiling: A dunk shot technique

Tomotaka Ohshima
1   Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Aichi
,
Reo Kawaguchi
2   Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi
,
Naoki Matsuo
2   Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi
,
Shigeru Miyachi
1   Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Aichi
2   Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi
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Objectives: Various endovascular approaches have been reported for patients with intracranial aneurysms. However, the safety of navigating a microcatheter into the aneurysm remains debatable. In this study, we evaluated a novel method “dunk shot technique,” in which a proximal balloon and a local balloon are used for navigation of a microcatheter into an aneurysm under challenging situations. Materials and Methods: We have reported two cases of unruptured internal carotid artery–superior hypothalamic artery aneurysm. An 8-F balloon-attached catheter was used as the guiding catheter. A local balloon catheter for neck remodeling and a microcatheter for coil insertion were navigated around the aneurysmal neck region. When it seemed difficult to navigate a microcatheter into an aneurysm, both the guiding balloon and a local balloon catheter were used for assistance. After inflation of the guiding balloon, the local balloon was inflated partially to negotiate the tip of the microcatheter. Results: The uncontrollable tip of the microcatheter could be intentionally moved by the local balloon. Conclusions: We evaluated the effectiveness of the balloon-assisted technique for the navigation of a microcatheter in cases with challenging anatomy. A little bit of direct effect to the tip of the microcatheter by a local balloon could produce effective outcomes under the proximal flow arrest.

Key-words:

Balloon-assisted technique - catheterization - coil embolization - intracranial aneurysm

Financial support and sponsorship

Nil.




Publication History

Received: 19 January 2021

Accepted: 17 March 2021

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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