2023 Volume 8 Issue 2 Pages 68-73
Objective: We report a case of coil embolization using a Marathon microcatheter for unruptured vertebral artery aneurysm with parent artery tight stenosis.
Case Presentation: A 59-year-old man was incidentally detected with right vertebral artery (VA) aneurysm of 10 mm in maximum diameter at the junction of the right VA and posterior inferior cerebellar artery (PICA). In addition, the VA beyond the VA–PICA junction came to an end, and the VA at the just proximal neck was tightly stenosed. He had suffered from sudden neck pain one year ago, and the MRI performed four years ago showed the patency of VA without aneurysmal formation. Taking his history and angiographical findings into consideration, this aneurysm could be caused by vertebral dissection. Coil embolization for this aneurysm was planned. After a SL-10 microcatheter was navigated into the aneurysm, the angiography revealed no visualization of the aneurysm and PICA because of the passage of the SL-10 beyond the tight stenosis of the proximal VA. After changing the microcatheter to Marathon, flow stagnation could be resolved and coil embolization was completed. The patient was discharged without any complications 3 days after the treatment.
Conclusion: While there have been some previous reports referred to aneurysmal coil embolization using a Marathon catheter, this report may be the first case that coil embolization using a Marathon was performed for the aneurysm located at the cerebral main trunk accompanied with tight stenosis. We think that a Marathon microcatheter may be one of the useful options for this situation.
