Purpose

An unfavorable vertebral artery (VA) anatomy occasionally inhibits a successful VA cannulation due to flow stagnation after catheterization. To preserve antegrade VA flow, we developed bilateral transradial catheter systems, referred to as the role-sharing technique, for coil embolization of basilar artery (BA) aneurysms associated with an unfavorable VA anatomy. This study aimed to evaluate the feasibility and safety of coil embolization using the role-sharing technique for BA aneurysms.

Methods

We retrospectively analyzed an institutional database of consecutive patients with BA aneurysm who underwent coil embolization using the role-sharing technique between July 2019 and January 2020. The study included seven consecutive patients. Bilateral transradial VA cannulation was performed using 3.2F catheters (TACTICS; Technocrat Corporation, Aichi, Japan) via 4F guiding sheaths placed in the subclavian artery. The following catheter systems were used: the triaxial system (4F guiding sheath/TACTICS/coil or stent delivery microcatheter) that has a specialized role in embolization and the biaxial system (4F guiding sheath/TACTICS) that has a specialized role in contrast injection during embolization procedure. The procedural success and procedure-related or vascular access site complications were assessed.

Results

All patients underwent a successful embolization procedure using the bilateral transradial catheter systems and none of them presented with flow stagnation, system instability, or other complications.

Conclusion

The role-sharing technique was shown to be a feasible and safe method for coil embolization of BA aneurysms associated with an unfavorable VA anatomy. This method may increase the success rate of transradial coil embolization for BA aneurysms.

中文翻译：

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双侧经桡动脉线圈栓塞与不利的椎动脉解剖相关的基底动脉瘤

目的

由于导管插入后血流停滞，不利的椎动脉 (VA) 解剖结构偶尔会抑制成功的 VA 插管。为了保持顺行 VA 血流，我们开发了双侧经桡动脉导管系统，称为角色共享技术，用于与不利的 VA 解剖结构相关的基底动脉 (BA) 动脉瘤的线圈栓塞。本研究旨在评估使用角色共享技术治疗 BA 动脉瘤的线圈栓塞的可行性和安全性。

方法

我们回顾性分析了 2019 年 7 月至 2020 年 1 月期间使用角色共享技术接受弹簧圈栓塞的 BA 动脉瘤连续患者的机构数据库。该研究包括七名连续患者。使用 3.2F 导管（TACTICS；Technocrat Corporation，Aichi，Japan）通过放置在锁骨下动脉中的 4F 引导鞘进行双侧经桡动脉 VA 插管。使用了以下导管系统：在栓塞术中具有特殊作用的三轴系统（4F 引导鞘/TACTICS/线圈或支架输送微导管）和在造影剂注射过程中具有特殊作用的双轴系统（4F 引导鞘/TACTICS）栓塞程序。对手术成功和手术相关或血管通路部位并发症进行了评估。

结果

所有患者均使用双侧经桡动脉系统成功进行栓塞手术，无一例出现血流停滞、系统不稳定或其他并发症。

结论

角色共享技术被证明是一种可行且安全的方法，用于与不利的 VA 解剖相关的 BA 动脉瘤的线圈栓塞。该方法可提高经桡动脉线圈栓塞治疗BA动脉瘤的成功率。