The "pipe-anchor" technique: A method for intra-aneurysmal loop reduction using a partially unsheathed pipeline stent

Area of Science:

• Endovascular neurosurgery
• Cerebrovascular diseases
• Medical device technology

Background:

• Large aneurysms pose challenges for endovascular navigation, often requiring complex techniques like the "around-the-world" maneuver for distal access.
• Traditional methods for stabilizing microcatheters in such cases may involve additional devices and complex exchanges.

Purpose of the Study:

• To describe a novel technique utilizing a pipeline stent for microcatheter stabilization during endovascular treatment of large aneurysms.
• To evaluate the feasibility and efficacy of the "pipe anchor" technique in achieving stable microcatheter positioning and successful stent deployment.

Main Methods:

• The "pipe anchor" technique involves partial deployment of a pipeline stent distal to the aneurysm to create an anchoring point.
• The microcatheter is stabilized by the partially deployed stent, allowing for gradual unsheathing and straightening within the aneurysm.
• This technique facilitates loop reduction and alignment of the microsystem with the inflow and outflow vessels for stent deployment.

Main Results:

• The technique was successfully applied in two patients with large cavernous segment aneurysms.
• Pipeline stents were deployed using a Phenom 0.027" microcatheter without thromboembolic complications.
• Follow-up imaging confirmed good stent apposition and contrast stagnation, indicating successful treatment.

Conclusions:

• The "pipe anchor" technique effectively uses the radial force of a partially deployed pipeline stent for anchoring and microcatheter stabilization.
• This method simplifies the procedure by eliminating the need for additional devices or complex exchange maneuvers.
• The technique is a valuable addition to the endovascular neurosurgeon's armamentarium for treating select large aneurysms.