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Microcatheter Re-Shaping Using Fusion Image in Coil Embolization: A Technical Note.

Akihiro Hirayama1, Kittipong Srivatanakul1, Hideaki Shigematsu1

  • 1Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.

Journal of Neuroendovascular Therapy
|July 28, 2023
PubMed
Summary

This study demonstrates effective microcatheter reshaping for aneurysm coiling using 3D fusion imaging. This technique aids navigation in complex anatomies, improving coil embolization success rates.

Keywords:
coil embolizationfusion imagemicrocatheter shaping

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Area of Science:

  • Interventional Neuroradiology
  • Medical Imaging

Background:

  • Aneurysm coiling requires precise microcatheter placement.
  • Complex vascular anatomy and aneurysm morphology can impede successful microcatheter navigation.

Purpose of the Study:

  • To evaluate the utility of microcatheter reshaping guided by fusion imaging.
  • To assess the effectiveness of this technique in challenging aneurysm cases.

Main Methods:

  • Utilized 3D digital subtraction angiography (3D-DSA) and non-subtraction, non-contrast (non-SC) rotational images for microcatheter 3D reconstruction.
  • Created 3D fusion images combining DSA and microcatheter positional data.
  • Reshaped microcatheters based on fusion image guidance.

Main Results:

  • Successfully reshaped microcatheters in two illustrative cases with tortuous arteries and complex aneurysms.
  • The technique facilitated optimal microcatheter alignment for coiling.
  • Applied successfully in 15 patients with ruptured and unruptured aneurysms, averaging 1.3 reshaping instances per patient.

Conclusions:

  • Microcatheter reshaping using 3D fusion imaging is an effective strategy for coil embolization.
  • This method is particularly beneficial for aneurysms with non-aligned parent arteries or tortuous proximal vessels.