title: A new endovascular technique for small anterior choroidal artery aneurysms. A consecutive series using the 3-catheter-protective technique.
abstract: BACKGROUND
  Endovascular treatment of small anterior choroidal artery (AChA) aneurysms can be challenging, especially if the AChA arises from the sac. Preserving its patency during embolization is as important as obliterating the aneurysm. We describe a variant of the "protective microcatheter technique" (PMT) in a series of six patients with AChA aneurysms where the AChA emerged from the sac.
  
  
  METHODS
  Three different microcatheters (KT) were used. The first microcatheter was placed in the AChA to protect it. A remodeling balloon-catheter was then positioned in the internal carotid artery to stabilize the coils during embolization and to control a potential rupture. The third microcatheter was finally used to coil the aneurysm.
  
  
  RESULTS
  Mean sac size of anterior choroidal artery aneurysms was 2×2×2mm. All aneurysms were successfully occluded. There was neither ischemic complication nor ruptured aneurysm during endovascular treatment. A final angiogram demonstrated AChA patency in all cases.
  
  
  CONCLUSIONS
  The 3KT-PMT for AChA aneurysms appears to be safe and effective to prevent AChA occlusion during aneurysm coiling, especially when the AChA arises from the sac.
authors.affiliation: Service de neuroradiologie diagnostique et interventionnelle, hôpital Guillaume-et-René-Laennec, CHU de Nantes, boulevard Jacques-Monod-Saint-Herblain, 44093 Nantes cedex 1, France. Electronic address: Helene.gimonet@hotmail.fr.
authors.forename: Hélène
authors.initials: H
authors.lastname: Gimonet
authors.affiliation: Service de neuroradiologie diagnostique et interventionnelle, hôpital Guillaume-et-René-Laennec, CHU de Nantes, boulevard Jacques-Monod-Saint-Herblain, 44093 Nantes cedex 1, France.
authors.forename: Hubert-Armand
authors.initials: HA
authors.lastname: Desal
authors.affiliation: Neuroradiologie Abteilung, Alfried Krupp Krankenhaus, Essen, Germany; Service de radiologie et neuroradiologie, centre hospitalier universitaire Vaudois, university of Lausanne, Lausanne, Switzerland.
authors.forename: Pascal J
authors.initials: PJ
authors.lastname: Mosimann
authors.affiliation: Neuroradiologie Abteilung, Alfried Krupp Krankenhaus, Essen, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Stracke
authors.affiliation: Service de neuroradiologie diagnostique et interventionnelle, hôpital Guillaume-et-René-Laennec, CHU de Nantes, boulevard Jacques-Monod-Saint-Herblain, 44093 Nantes cedex 1, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Daumas-Duport
authors.affiliation: Service de neuroradiologie diagnostique et interventionnelle, hôpital Guillaume-et-René-Laennec, CHU de Nantes, boulevard Jacques-Monod-Saint-Herblain, 44093 Nantes cedex 1, France.
authors.forename: Alina
authors.initials: A
authors.lastname: Lintia-Gaultier
authors.affiliation: Service de neuroradiologie diagnostique et interventionnelle, hôpital Guillaume-et-René-Laennec, CHU de Nantes, boulevard Jacques-Monod-Saint-Herblain, 44093 Nantes cedex 1, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Bourcier
authors.affiliation: Neuroradiologie Abteilung, Alfried Krupp Krankenhaus, Essen, Germany.
authors.forename: René
authors.initials: R
authors.lastname: Chapot
mesh_terms: D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D057785:Catheters; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D016896:Treatment Outcome
keywords: Anterior choroidal artery aneurysms; Coil embolization; Protective microcatheter technique; Remodeling balloon