title: Double wire technique for stenting tortuous cerebral vessels.
abstract: The failure to catheterize distal vessels may preclude optimal endovascular intervention. We present a double wire technique to facilitate the selective placement of catheters into tortuous vasculature when a single wire and catheter technique does not suffice. A wide necked middle cerebral artery (MCA) aneurysm incorporated the origin of the inferior MCA trunk, and despite successful passage of a wire into the distal MCA, the catheter could not be advanced beyond 2 sharp turns at the inferior trunk origin. A second wire was passed through the catheter into the inferior trunk providing adequate stability for advancement of the catheter into the vessel. The distal vessel was successfully catheterized and a stent was placed without complication. The double wire technique may allow the passage of catheters into vessels that are otherwise inaccessible because of tortuosity.
authors.affiliation: Department of Neurological Surgery, Rush University Medical Center and Rush Medical College, Chicago, Illinois 60612, USA. brainaneurysm@mac.com
authors.forename: Demetrius Klee
authors.initials: DK
authors.lastname: Lopes
authors.forename: Andrew Kelly
authors.initials: AK
authors.lastname: Johnson
authors.forename: Cristian Ariel
authors.initials: CA
authors.lastname: Schreiner
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography / Q000379:methods; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D015641:Radiography, Interventional; D015607:Stents; D016896:Treatment Outcome; D062666:Vascular Access Devices