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Updated: Oct 28, 2025
Simulator Training for Endovascular Neurosurgery
Published on: May 6, 2020
Local Balloon-Assisted Navigation of a Microcatheter into an Aneurysm during Intracranial Aneurysmal Coiling: A Dunk
Tomotaka Ohshima1, Reo Kawaguchi2, Naoki Matsuo2
1Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Aichi, Japan.
Objectives:
Various endovascular approaches have been reported for patients with intracranial aneurysms. However, the safety of navigating a microcatheter into the aneurysm remains debatable. In this study, we evaluated a novel method "dunk shot technique," in which a proximal balloon and a local balloon are used for navigation of a microcatheter into an aneurysm under challenging situations.
Materials And Methods:
We have reported two cases of unruptured internal carotid artery-superior hypothalamic artery aneurysm. An 8-F balloon-attached catheter was used as the guiding catheter. A local balloon catheter for neck remodeling and a microcatheter for coil insertion were navigated around the aneurysmal neck region. When it seemed difficult to navigate a microcatheter into an aneurysm, both the guiding balloon and a local balloon catheter were used for assistance. After inflation of the guiding balloon, the local balloon was inflated partially to negotiate the tip of the microcatheter.
Results:
The uncontrollable tip of the microcatheter could be intentionally moved by the local balloon.
Conclusions:
We evaluated the effectiveness of the balloon-assisted technique for the navigation of a microcatheter in cases with challenging anatomy. A little bit of direct effect to the tip of the microcatheter by a local balloon could produce effective outcomes under the proximal flow arrest.
