title: Single-center experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms.
abstract: OBJECTIVE
  The endovascular treatment of wide-necked aneurysms can be technically challenging due to distal coil migration or impingement of the parent vessel. In this paper, the authors illustrate an alternative method for the treatment of wide-necked intracranial aneurysms using a dual microcatheter technique.
  
  
  METHODS
  The authors' first 100 consecutive patients who underwent coil embolization of a wide-necked aneurysm using a dual microcatheter technique are reported. With this technique, 2 microcatheters are used to introduce coils into the aneurysm. The coils are deployed either sequentially or concurrently to form a stable construct and prevent coil herniation or migration. Angiographic and clinical outcomes are reported.
  
  
  RESULTS
  The technical success rate of the dual microcatheter technique is 91% with a morbidity and mortality of 1% and 2%, respectively. Clinical outcomes are excellent with 93% of patients demonstrating a modified Rankin Scale score of 0-2 at long-term follow-up regardless of their score at presentation. Retreatment rates are 18%.
  
  
  CONCLUSIONS
  The dual microcatheter technique may be a safe and efficacious first line of treatment for widenecked aneurysms.
authors.affiliation: Departments of Radiology and Medical Imaging and.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Durst
authors.forename: Robert M
authors.initials: RM
authors.lastname: Starke
authors.forename: John R
authors.initials: JR
authors.lastname: Gaughen
authors.forename: Scott
authors.initials: S
authors.lastname: Geraghty
authors.forename: K Derek
authors.initials: KD
authors.lastname: Kreitel
authors.forename: Ricky
authors.initials: R
authors.lastname: Medel
authors.forename: Nicholas
authors.initials: N
authors.lastname: Demartini
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Liu
authors.forename: Mary E
authors.initials: ME
authors.lastname: Jensen
authors.forename: Avery J
authors.initials: AJ
authors.lastname: Evans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D012449:Safety; D016896:Treatment Outcome
keywords: aneurysm; dual; interventional neurosurgery; mRS = modified Rankin Scale; microcatheter; outcomes; vascular disorders; wide-necked