Loop microcatheter technique for coil embolization of paraclinoid aneurysms

Area of Science:

• Neurosurgery
• Interventional Neuroradiology
• Vascular Neurology

Background:

• Paraclinoid aneurysms present challenges for coil embolization due to unstable microcatheter positioning.
• Despite a low rupture risk, achieving stable access is crucial for effective treatment.

Purpose of the Study:

• To present a novel loop microcatheter technique for stable coil embolization of paraclinoid aneurysms.
• To evaluate the safety and efficacy of this technique in achieving aneurysm occlusion.

Main Methods:

• 34 patients with paraclinoid aneurysms underwent coil embolization using a shaped distal microcatheter loop.
• The technique involves positioning the proximal loop against the aneurysm wall for stability.
• Stent-assisted coiling was used in 19 cases; outcomes assessed by Raymond classification and modified Rankin Scale (mRS).

Main Results:

• Successful aneurysm occlusion (Raymond score 1 or 2) was achieved in 94.1% of patients.
• Satisfactory coil packing density (≥31%) was achieved in 71% of patients.
• All patients achieved excellent functional outcomes (mRS 0-1) at 6-month follow-up with stable coil positions.

Conclusions:

• The loop microcatheter technique provides a safe and stable method for coil embolization of paraclinoid aneurysms.
• This technique demonstrates high efficacy and excellent clinical outcomes.
• The procedural concept is adaptable for aneurysms in other vascular regions.