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Retrograde stenting through anterior communicating artery in coil embolization of the posterior communicating artery aneurysm: contralateral approach
Journal of Neuroradiology ( IF 3.0 ) Pub Date : 2019-06-21 , DOI: 10.1016/j.neurad.2019.05.008
Hyon Jo Kwon 1 , Young Dae Cho 2 , Jeong Wook Lim 1 , Hyeon-Song Koh 1 , Dong Hyun Yoo 2 , Hyun-Seung Kang 3 , Moon Hee Han 4
Affiliation  

During coil embolization of wide-necked posterior communicating artery (PcomA) aneurysms, stent assistance is sometimes limited if PcomA is acutely angled at its origins from saccular neck. Herein, we present two instances where retrograde stenting was used for coil embolization of PcomA aneurysms. Both procedures involved a contralateral approach via anterior communicating artery (AcomA). To achieve this, the stent-delivery microcatheter was inserted retrograde from contralateral to ipsilateral internal carotid artery (ICA) across AcomA, arriving at ipsilateral PcomA. A separate microcatheter, passed through ipsilateral ICA, was then used to select the aneurysm sac for coil delivery. Coil embolization ultimately took place under protection of a horizontally placed stent extending from PcomA to terminal ICA. Each aneurysm was properly coiled and occluded, without procedural complications. This stenting technique is a reasonable option, offering a means of strategic coil embolization in wide-necked PcomA aneurysms and providing complete neck coverage through contralateral access.



中文翻译:

经前交通动脉逆行支架置入线圈栓塞后交通动脉瘤:对侧入路

在对宽颈后交通动脉 (PcomA) 动脉瘤进行弹簧圈栓塞期间,如果 PcomA 在其起源于囊状颈的角度呈锐角,则支架辅助有时会受到限制。在此,我们介绍了两个使用逆行支架置入术对 PcomA 动脉瘤进行线圈栓塞的实例。这两种手术都涉及通过前交通动脉 (AcomA) 的对侧入路。为此,支架输送微导管从对侧逆行插入到同侧颈内动脉 (ICA),穿过 AcomA,到达同侧 PcomA。然后使用穿过同侧 ICA 的单独微导管选择动脉瘤囊进行线圈输送。线圈栓塞最终发生在水平放置的支架的保护下,支架从 PcomA 延伸到末端 ICA。每个动脉瘤都被正确地盘绕和闭塞,没有手术并发症。这种支架技术是一种合理的选择,为宽颈 PcomA 动脉瘤提供了一种策略性线圈栓塞的方法,并通过对侧通路提供完整的颈部覆盖。

更新日期:2019-06-21
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