A double catheter technique for elongated middle cerebral artery bifurcation aneurysm. A case report

We report a case of an elongated middle cerebral artery bifurcation aneurysm which was managed using an endovascular double catheter technique. After positioning two microcatheters, one at the distal dome and the other at the proximal dome, two coils were subsequently deployed through each microcatheter.We created a proximal supporting coil frame using one microcatheter and preserved the parent artery, and then deposited subsequent packing coils at the distal aneurysm sac region using the other microcatheter. The proximal framing coils did not detach prior to obtaining satisfactory aneurysm packing through the distally positioned microcatheter. This approach allowed for the proximal coil to be withdrawn if there was any evidence of the proximal coil frame changing shape or of parent artery protrusion. This double microcatheter technique provided safe and effective treatment of an elongated middle cerebral artery bifurcation aneurysm.