PDF(Pubmed)
Abstract：
UNASSIGNED: It is important to guarantee intra-aneurysmal stability of microcatheters during coil embolization. We developed a simple and reproducible microcatheter shaping method for medially-directed paraclinoid internal carotid artery aneurysms.
UNASSIGNED: An injection needle cap was used to make a smooth curve on the mandrel, which was first wound around the back end of the cap to create a primary curve. Next, a secondary curve was created using near the tip of the cap. Thus, a two-dimensional (2D), pigtail-shaped mandrel with a two-stage curve was created. The pigtail-shaped mandrel was inserted from the tip of a straight microcatheter and heat-shaped using a heat gun. Lastly, a microcatheter having a curve whose tip was approximately 6 mm longer than that of the preshaped J was created. We evaluated the ease of navigating the microcatheter into the aneurysm and its stability during coil embolization.
UNASSIGNED: In all, 34 consecutive medially-directed paraclinoid internal carotid artery aneurysms were treated using the shaped catheters. It took 50-300 seconds (intermediate value: 90 seconds) from inserting the microcatheter with a microguide wire to navigate and place it into an aneurysm. There were no cases that required reshaping of the microcatheters during navigation into the aneurysm. There were no cases that resulted in kickback of the microcatheters from the aneurysm during coil placement, and microcatheter stability was good until the end of the procedure. In all, 12 cases required the balloon-assisted technique and three cases required stent-assisted coiling. The angiographic outcomes immediately after embolization were as follows: 25 cases (73.5%) with complete occlusion; 3 cases (8.8%) with dome filling; and 6 cases (17.6%) with a neck remnant. There were no perioperative complications.
UNASSIGNED: The shaping method with a pigtail-shaped mandrel using an injection needle cap is simple and reproducible, and is useful for medially-directed paraclinoid internal carotid artery aneurysms.
UNASSIGNED: An injection needle cap was used to make a smooth curve on the mandrel, which was first wound around the back end of the cap to create a primary curve. Next, a secondary curve was created using near the tip of the cap. Thus, a two-dimensional (2D), pigtail-shaped mandrel with a two-stage curve was created. The pigtail-shaped mandrel was inserted from the tip of a straight microcatheter and heat-shaped using a heat gun. Lastly, a microcatheter having a curve whose tip was approximately 6 mm longer than that of the preshaped J was created. We evaluated the ease of navigating the microcatheter into the aneurysm and its stability during coil embolization.
UNASSIGNED: In all, 34 consecutive medially-directed paraclinoid internal carotid artery aneurysms were treated using the shaped catheters. It took 50-300 seconds (intermediate value: 90 seconds) from inserting the microcatheter with a microguide wire to navigate and place it into an aneurysm. There were no cases that required reshaping of the microcatheters during navigation into the aneurysm. There were no cases that resulted in kickback of the microcatheters from the aneurysm during coil placement, and microcatheter stability was good until the end of the procedure. In all, 12 cases required the balloon-assisted technique and three cases required stent-assisted coiling. The angiographic outcomes immediately after embolization were as follows: 25 cases (73.5%) with complete occlusion; 3 cases (8.8%) with dome filling; and 6 cases (17.6%) with a neck remnant. There were no perioperative complications.
UNASSIGNED: The shaping method with a pigtail-shaped mandrel using an injection needle cap is simple and reproducible, and is useful for medially-directed paraclinoid internal carotid artery aneurysms.
摘要：
■重要的是在线圈栓塞期间保证微导管的动脉瘤内稳定性。我们开发了一种简单且可重复的微导管成形方法，用于内侧定向的颈内动脉突旁动脉瘤。
■使用注射针帽在心轴上形成平滑的曲线，它首先缠绕在盖子的后端以形成主曲线。接下来,使用靠近帽的尖端创建二次曲线。因此，二维(2D)，创建了具有两级曲线的尾纤形心轴。从直的微导管的尖端插入尾纤形的心轴并使用热风枪热成形。最后,创建了具有尖端比预成形J的尖端长约6mm的曲线的微导管。我们评估了将微导管导航到动脉瘤中的难易程度及其在线圈栓塞过程中的稳定性。
■总之，使用成形的导管治疗了34例连续的内侧定向颈内动脉动脉瘤。从用微导线插入微导管以导航并将其置于动脉瘤中需要50-300秒(中间值:90秒)。在导航到动脉瘤中的过程中，没有病例需要对微导管进行重塑。在线圈放置期间，没有导致微导管从动脉瘤反冲的情况。微导管稳定性良好，直到手术结束。总之,12例需要球囊辅助技术，3例需要支架辅助盘绕。栓塞后立即的血管造影结果如下：完全闭塞25例（73.5％）；圆顶填充3例（8.8％）；颈部残留6例（17.6％）。无围手术期并发症。
■使用注射针帽的尾纤形心轴的成型方法简单且可重复，对于内侧方向的颈内动脉突旁动脉瘤是有用的。
■使用注射针帽在心轴上形成平滑的曲线，它首先缠绕在盖子的后端以形成主曲线。接下来,使用靠近帽的尖端创建二次曲线。因此，二维(2D)，创建了具有两级曲线的尾纤形心轴。从直的微导管的尖端插入尾纤形的心轴并使用热风枪热成形。最后,创建了具有尖端比预成形J的尖端长约6mm的曲线的微导管。我们评估了将微导管导航到动脉瘤中的难易程度及其在线圈栓塞过程中的稳定性。
■总之，使用成形的导管治疗了34例连续的内侧定向颈内动脉动脉瘤。从用微导线插入微导管以导航并将其置于动脉瘤中需要50-300秒(中间值:90秒)。在导航到动脉瘤中的过程中，没有病例需要对微导管进行重塑。在线圈放置期间，没有导致微导管从动脉瘤反冲的情况。微导管稳定性良好，直到手术结束。总之,12例需要球囊辅助技术，3例需要支架辅助盘绕。栓塞后立即的血管造影结果如下：完全闭塞25例（73.5％）；圆顶填充3例（8.8％）；颈部残留6例（17.6％）。无围手术期并发症。
■使用注射针帽的尾纤形心轴的成型方法简单且可重复，对于内侧方向的颈内动脉突旁动脉瘤是有用的。
