Optimizing Microcatheter Loop Correction: A Study on Anchoring Techniques with Drawn-filled Tube Flow Diverters and...

Treating complex aneurysms, particularly in distal vessels, often involves loop catheterization, which can fail due to challenging anatomy. Alternative anchoring techniques using retrievable and flow diverter stents have shown promise but lack comprehensive evaluation in these scenarios. This study investigates the efficacy of anchoring techniques with retrievable and flow diverter stents for correcting catheter loops in complex aneurysm cases, especially in distal vessels.

A retrospective analysis of 380 aneurysm cases treated endovascularly identified 50 as complex, where outflow artery catheterization via a loop technique was required. In 14 cases where standard maneuvers failed, 2 anchoring techniques were employed: 1) stent retrieval anchor, deploying a stent retriever to secure and correct the microcatheter, and 2) flow diverter anchor, using a partially deployed flow diverter stent to achieve the same. Outcomes were assessed for technical success, complications, and vessel patency.

Stent anchoring was successful in all 14 cases (100% technical success) with no complications such as aneurysm perforation, stent thrombosis, or vessel obstruction. Both techniques provided adequate radial force for stable anchoring in distal vessels, allowing stent deployment without the need for a microcatheter exchange.

Anchoring techniques using retrievable and flow diverter stents provide a safe, efficient solution for managing complex aneurysms, particularly in distal vessels. This approach eliminates the need for catheter exchanges, potentially reducing procedure time and complication risks. Further multicenter studies are recommended to validate these findings.