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Related Experiment Video

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Magnetically-Assisted Remote Controlled Microcatheter Tip Deflection under Magnetic Resonance Imaging
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The bumper technique for advancing a large profile microcatheter.

Christopher P Kellner1, Alexander G Chartrain1, Claire Schwegel1

  • 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA.

Journal of Neurointerventional Surgery
|March 11, 2017
PubMed
Summary

Navigating microcatheters past wide neck aneurysms can be challenging. A novel

Keywords:
AneurysmAngiographyCatheterFlow DiverterTechnique

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Area of Science:

  • Interventional Neuroradiology
  • Cerebrovascular Surgery

Background:

  • Maneuvering microcatheters past wide neck aneurysms and in challenging anatomical locations presents significant technical difficulties for operators.
  • Existing techniques to overcome these challenges during endovascular procedures are limited, necessitating innovative approaches.

Observation:

  • A case report details a 56-year-old woman with a 16 mm ophthalmic artery aneurysm where the microcatheter repeatedly snagged the distal aneurysm lip.
  • This snagging prevented the successful delivery of a flow diverter into the distal parent vessel, highlighting a common procedural obstacle.

Findings:

  • A novel technique, termed the 'bumper technique,' was developed to address microcatheter navigation issues.
  • This technique involves introducing a second microguidewire alongside the primary microcatheter to cover the distal aneurysm lip.
  • The second guidewire successfully deflected the microcatheter, enabling passage into the distal parent vessel and facilitating flow diverter delivery.

Implications:

  • The 'bumper technique' offers a practical solution for overcoming microcatheter navigation difficulties in wide neck aneurysms.
  • This technique has the potential to improve the success rates of endovascular treatments for complex cerebrovascular aneurysms.
  • Further adoption and validation of this technique could enhance procedural efficiency and patient outcomes in neurointerventional procedures.