最大径3mm以下の微小脳動脈瘤コイル塞栓術

抄録

Endovascular coil embolization of very small aneurysms (＜ 3 mm in maximum diameter) remains challenging and requires scrupulous attention to detail during treatment to overcome technical difficulties and mitigate high complication rates. We focused on techniques for positioning microcatheters into aneurysms.

In principle, we placed a balloon microcatheter across or proximal to the aneurysm neck and adopted a microcatheter that is usually shaped with steam according to the three-dimensional relationship of the vascular structure. If the angle between the long axis of the aneurysm and that of the parent artery is approximately 90°, we pulled back the microcatheter from the distal site to place the catheter in the aneurysm. In cases where the long axis of the aneurysm is nearly parallel to that of the parent artery, we often adopt the catheterization technique using of a preceding coil loop or, in anatomically inevitable cases, a preceding micro guidewire.

In this case report, we have described our endovascular coil embolization technique for very small aneurysms, focusing on the method of positioning the microcatheter into the aneurysm.