First Experience with Endovascular Treatment of Cerebral Aneurysms Using Sub-Marker Catheter

Prehension of the position of the microcatheter tip under fluoroscopy during cerebral aneurysm embolization is critical to prevent intraoperative rupture of the aneurysm, even if the first marker at the tip is obscured by coils in the aneurysm. This study presents our initial experience with a sub-marker catheter, which includes an additional marker positioned 5 mm from the tip, designed to facilitate accurate positioning of the microcatheter tip.

We analyzed cases of cerebral aneurysms treated with sub-marker catheters at our hospital from July 2022 to September 2023. Single catheter embolization served as the primary treatment option, with balloon-assisted or stent-assisted techniques utilized only when necessary.

During the study period, 18 patients with cerebral aneurysms were treated using sub-marker catheters. The median age of these patients was 65 years, comprising 8 men and 10 women. The aneurysms had a median maximum diameter of 6.2 mm, ranging from 5.0 to 16.8 mm. Among the 18 treated patients, 14 had unruptured aneurysms and 4 had ruptured aneurysms. Treatment methods included single catheter embolization in 10 patients, double catheter embolization in 3, stent-assisted embolization in 3, balloon-assisted embolization in 1, and flow diverter placement combined with coil embolization in 1. The sub-marker was consistently visible under fluoroscopy, aiding the precise positioning of the microcatheter tip without interference from the coils. No complications occurred, and successful embolization was achieved in all cases.

The sub-marker catheter appears valuable for safely performing aneurysm embolization.