Technique for shaping microcatheter tips in coil embolization of paraclinoid aneurysms using full-scale volume rendering images of 3D rotational angiography.
BACKGROUND
In coil embolization of paraclinoid aneurysms, it is sometimes difficult to introduce and stabilize microcatheter tips in the aneurysms. We report a new technique for shaping microcatheter tips in the coil embolization of paraclinoid aneurysms.


METHODS
From May 2007 to May 2008, this new technique was applied to 10 paraclinoid aneurysms undergoing coil embolization. Before coil embolization, 3D rotational angiography was performed, and volume-rendering images were reconstructed. Vinyl-coated handicraft wire was shaped 3-dimensionally to fit full-scale volume-rendering images on the monitor, from the C5 portion of the internal carotid artery to the center of the dome of the aneurysm from various angles. The microcatheter tip was then shaped with steam to fit the vinyl-coated wire. Thereafter, the microcatheter tip was introduced into the aneurysm and coil embolization was performed.


RESULTS
Microcatheter tips could be easily shaped and could be introduced smoothly into aneurysms, and were stable during coil embolization.


CONCLUSIONS
This technique is feasible for shaping microcatheter tips precisely for coil embolization of paraclinoid aneurysms.
Center for Endovascular Neurosurgery, Osaka Neurological Institute, Toyonaka, Osaka, Japan. stshto@aol.com
S
S
Toyota
Y
Y
Fujimoto
F
F
Iwamoto
A
A
Wakayama
T
T
Yoshimine
D001807:Blood Vessel Prosthesis; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D002533:Cerebral Angiography / Q000379:methods*; D020878:Device Removal / Q000379:methods; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design / Q000379:methods; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000295:instrumentation / Q000379:methods*; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000517:prevention & control; D013100:Sphenoid Bone / Q000033:anatomy & histology / Q000601:surgery