Modified buddy wire technique for coil embolization of posterior circulation aneurysms

Area of Science:

• Neurosurgery
• Interventional Radiology
• Vascular Surgery

Background:

• Posterior circulation aneurysms often present challenges for endovascular treatment due to vertebral artery tortuosity or small caliber.
• Guiding catheter placement is frequently unsuccessful in these anatomically difficult cases.
• Coil embolization remains a critical treatment option for poor-grade patients or surgically inaccessible aneurysms.

Observation:

• A modified buddy wire technique was employed to stabilize a guiding catheter in three patients with posterior circulation aneurysms.
• The technique allowed for secure placement and support of the microcatheter.
• The guiding catheter was stabilized in the subclavian artery.

Findings:

• Successful coil embolization was achieved in all three patients utilizing the modified buddy wire technique.
• The procedure was performed safely without any intraprocedural complications.
• The technique effectively overcame the limitations posed by tortuous or narrow vertebral arteries.

Implications:

• The modified buddy wire technique expands endovascular treatment possibilities for complex posterior circulation aneurysms.
• This method offers a viable alternative for patients who might otherwise have limited or no treatment options.
• It enhances the safety and feasibility of coil embolization in challenging vascular anatomies.