Single-center experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms

Christopher R. Durst, Robert M. Starke, John R. Gaughen, Scott Geraghty, K. Derek Kreitel, Ricky Medel, Nicholas Demartini, Kenneth Liu, Mary E. Jensen, Avery J. Evans

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Object. 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.

Original languageEnglish (US)
Pages (from-to)1093-1101
Number of pages9
JournalJournal of neurosurgery
Volume121
Issue number5
DOIs
StatePublished - Nov 1 2014

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Endovascular Procedures
Aneurysm
Retreatment
Intracranial Aneurysm
Therapeutics
Morbidity
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Durst, C. R., Starke, R. M., Gaughen, J. R., Geraghty, S., Kreitel, K. D., Medel, R., ... Evans, A. J. (2014). Single-center experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms. Journal of neurosurgery, 121(5), 1093-1101. https://doi.org/10.3171/2014.7.JNS132237
Durst, Christopher R. ; Starke, Robert M. ; Gaughen, John R. ; Geraghty, Scott ; Kreitel, K. Derek ; Medel, Ricky ; Demartini, Nicholas ; Liu, Kenneth ; Jensen, Mary E. ; Evans, Avery J. / Single-center experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms. In: Journal of neurosurgery. 2014 ; Vol. 121, No. 5. pp. 1093-1101.
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Durst, CR, Starke, RM, Gaughen, JR, Geraghty, S, Kreitel, KD, Medel, R, Demartini, N, Liu, K, Jensen, ME & Evans, AJ 2014, 'Single-center experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms', Journal of neurosurgery, vol. 121, no. 5, pp. 1093-1101. https://doi.org/10.3171/2014.7.JNS132237

Single-center experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms. / Durst, Christopher R.; Starke, Robert M.; Gaughen, John R.; Geraghty, Scott; Kreitel, K. Derek; Medel, Ricky; Demartini, Nicholas; Liu, Kenneth; Jensen, Mary E.; Evans, Avery J.

In: Journal of neurosurgery, Vol. 121, No. 5, 01.11.2014, p. 1093-1101.

Research output: Contribution to journalArticle

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AU - Medel, Ricky

AU - Demartini, Nicholas

AU - Liu, Kenneth

AU - Jensen, Mary E.

AU - Evans, Avery J.

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N2 - Object. 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.

AB - Object. 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.

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