Background

Delivery of most flow diverters (FD) requires larger, and thus stiffer microcatheters (0.021–0.027in.) which can pose challenges to intracranial navigation. The concomitant use of two microwires within one microcatheter, also known as the buddy-wire technique, may be helpful for navigation and support in challenging situations.

Methods

We analyzed all flow diverter procedures in our prospectively collected database. We recorded all patient-related, anatomical and procedural information. We performed univariate statistics and technical descriptions.

Results

In total, 208 consecutive patients treated with a FD at our institution between July 2014 and August 2020 were retrospectively analyzed. In 17 patients the buddy-wire technique was used (mean age 63 years, range 31–87 years: 16 female). Aneurysms were located at the petrous, cavernous, supraophthalmic internal carotid artery, and a proximal M2 branch in 2, 7, 7 and 1 patient(s), respectively. In all cases a 0.027in. microcatheter was used for device deployment. In 14 patients with a wide-necked aneurysm the buddy-wire provided additional support to advance the microcatheter and mitigated the ledge between the aneurysm neck and the parent artery or a side branch. In two giant cavernous aneurysms treated with telescoping FDs, the buddy-wire was used to re-enter the proximal end of the foreshortened FD.

Conclusion

The buddy-wire is a useful technique in FD procedures to prevent herniation of the microcatheter into the aneurysm sack, in wide-necked aneurysms to mitigate the ledge effect between the aneurysm neck and the parent artery where the microcatheter tip may get stuck, or to enable re-entry into a foreshortened FD.

中文翻译：

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当两个比一个好

背景

大多数分流器 (FD) 的输送需要更大、因此更硬的微导管 (0.021–0.027 英寸)，这可能对颅内导航构成挑战。在一根微导管内同时使用两条微线，也称为伙伴线技术，可能有助于在具有挑战性的情况下进行导航和支持。

方法

我们分析了我们预期收集的数据库中的所有分流器程序。我们记录了所有与患者相关的解剖学和程序信息。我们进行了单变量统计和技术描述。

结果

回顾性分析了 2014 年 7 月至 2020 年 8 月期间在我们机构接受 FD 治疗的 208 名连续患者。在 17 名患者中使用了 buddy-wire 技术（平均年龄 63 岁，范围 31-87 岁：16 名女性）。分别有 2、7、7 和 1 名患者的动脉瘤位于岩岩、海绵状血管、眼上颈内动脉和近端 M2 分支。在所有情况下为 0.027 英寸。微导管用于设备部署。在 14 名患有宽颈动脉瘤的患者中，buddy-wire 为推进微导管提供了额外的支持，并减轻了动脉瘤颈与载瘤动脉或侧支之间的突出。在用伸缩式 FD 治疗的两个巨大海绵状动脉瘤中，使用 buddy-wire 重新进入缩短的 FD 的近端。

结论

在 FD 手术中，buddy-wire 是一种有用的技术，可防止微导管突出到动脉瘤袋中，在宽颈动脉瘤中，以减轻动脉瘤颈部和载瘤动脉之间微导管尖端可能卡住的壁架效应，或允许重新进入缩短的 FD。