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Parent Vessel Occlusion via the Balloon-Assisted, Dual Microcatheter Technique
Gregory Glauser1, Brian Patrick Walcott2,3, Omar Aftab Choudhri1
1Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Abstract:
Endovascular parent vessel sacrifice is an established technique used to treat vascular pathology and tumor infiltration of blood vessels. In high-flow vessels, such as the carotid artery or vertebral artery, distal coil migration and embolization are concerns. A method to mitigate this risk would improve the safety profile of the procedure. Five patients undergoing parent vessel sacrifice were retrospectively identified (from June 2018 to May 2019) for the purpose of illustrating this high-flow parent vessel occlusion technique. The technique utilizes a proximal dual-lumen balloon microcatheter inflated for blood flow arrest. The balloon-assisted, dual microcatheter technique is useful for occlusion of high-flow parent arteries. Because it utilizes both flow arrest and a tethered coil backstop, precise occlusion of a vessel can be achieved.
Insights
This study introduces a dual microcatheter technique for endovascular parent vessel sacrifice in high-flow arteries. The method uses flow arrest and a coil backstop to prevent coil migration, enhancing procedural safety.
Area of Science:
- Interventional Neurology
- Vascular Surgery
- Medical Device Technology
Background:
- Endovascular parent vessel sacrifice is used for vascular pathologies and tumors.
- High-flow vessels like the carotid and vertebral arteries pose risks of distal coil migration.
- Improving safety in these procedures is crucial.
Observation:
- A retrospective review of five patients undergoing parent vessel sacrifice was conducted.
- The technique involves a proximal dual-lumen balloon microcatheter for flow arrest.
- This method was used to illustrate a high-flow parent vessel occlusion technique.
Findings:
- The balloon-assisted, dual microcatheter technique effectively achieves occlusion in high-flow parent arteries.
- It utilizes both flow arrest and a tethered coil backstop.
- Precise vessel occlusion is achieved, mitigating risks of coil migration.
Implications:
- This technique offers an improved safety profile for endovascular parent vessel sacrifice.
- It provides a reliable method for treating vascular issues in high-flow arteries.
- The approach enhances the precision and safety of neurovascular interventions.
