Abstract
Objective: During balloon-assisted coil embolization of intracranial aneurysms with the HyperForm balloon microcatheter (HyperForm; eV3 Neurovascular, Irvine, CA, USA) we encountered an instance where the balloon was inflated unexpectedly when a guidewire was fixed by the thumbwheel of the Y-connector provided with the one-touch slide-type valve. We report this phenomenon with a description of procedural precautions.
Method: Between April 2011 and December 2012, balloon-assisted coil embolization with HyperForm was performed in 24 patients with intracranial aneurysms at our facility. The Y-connectors that were used to connect the HyperForm were provided with either a one-touch slide-type valve (13 patients) or a conventional throttle valve (11 patients).
Result: The balloon inflated in all 13 patients when the guidewire was fixed by turning the thumbwheel of the Y-connector provided with the one-touch slide-type valve during the setup of HyperForm. In Y-connectors with the conventional throttle valve, balloon inflation was not observed after performing the same procedure.
Conclusion: The Y-connector provided with the one-touch slide-type valve is beneficial for reducing blood loss from cases requiring the frequent insertion and removal of devices. However, if the Y-connector is used with a single-lumen balloon catheter, which is inflated after the tip opening is closed with a guidewire, turning the thumbwheel will increase the internal pressure of the catheter and consequently pose a risk of unexpected balloon inflation.
