Positional Relationship between Two Microcatheters according to the Navigation Sequence within the Curved Vessel in...

Area of Science:

• Neurosurgery
• Interventional Radiology
• Medical Device Engineering

Background:

• Neuroendovascular treatment frequently involves navigating multiple microcatheters within complex intracranial vasculature.
• Understanding catheter interaction is crucial for optimizing procedural safety and efficacy.

Purpose of the Study:

• To investigate the positional relationship between two microcatheters based on their guiding order in vitro.
• To test the hypothesis that the first-guided catheter follows an inner path and the second-guided catheter follows an outer path in curved vessels.

Main Methods:

• In vitro experimental study using a silicone vascular aneurysmal model.
• Utilized a microcatheter and a balloon catheter to simulate neuroendovascular navigation.
• Observed catheter arrangement based on the sequence of insertion.

Main Results:

• The in vitro study confirmed the hypothesis: the first-guided catheter occupied the inner lumen, and the second-guided catheter occupied the outer lumen in a simulated bent blood vessel.
• This observed positional relationship was consistent with findings during actual balloon-assisted coil embolization procedures.

Conclusions:

• The order of microcatheter guidance significantly influences their spatial arrangement within intracranial vessels, particularly in curved segments.
• This finding is critical for procedures like balloon-assisted and stent-assisted coiling, especially when employing a jailed microcatheter technique.