title: The wire anchor loop traction (WALT) maneuver.
abstract: Crossing the neck of large complex intracranial aneurysms for the purposes of stent deployment can be challenging using standard over the wire techniques. We describe a novel yet simple technique for straightening out the loop formed within a large intracranial aneurysm, which is often required in order to cross the aneurysm neck into the distal branch. Both the microcatheter and microwire are initially introduced into the distal vasculature, followed by withdrawal of the microwire to a point parallel to the distal exiting branch. The microcatheter and microwire are then gently withdrawn and a series of maneuvers to gradually reduce the loop is performed, obviating the need for distal purchase in the form of a stent, balloon, or coil, which have previously been described to maintain distal purchase.
authors.affiliation: Diagnostic and Therapeutic Neuroradiology, St Michael's Hospital, Toronto, Canada.
authors.forename: Khaled
authors.initials: K
authors.lastname: Effendi
authors.affiliation: Diagnostic and Therapeutic Neuroradiology, St Michael's Hospital, Toronto, Canada.
authors.forename: Raphael Hillel
authors.initials: RH
authors.lastname: Sacho
authors.affiliation: Division of Neuroradiology, Department of Medical Imaging, Centre Hospitalier Universitaire de Sherbrooke, University of Sherbrooke, Sherbrook, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Belzile
authors.affiliation: Diagnostic and Therapeutic Neuroradiology, St Michael's Hospital, Toronto, Canada.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Marotta
mesh_terms: D000368:Aged; D057785:Catheters; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D015607:Stents; D014143:Traction
keywords: Aneurysm; Catheter; Stent; Technique; guidewire