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Year : 2021  |  Volume : 16  |  Issue : 2  |  Page : 384-386

Local balloon-assisted navigation of a microcatheter into an aneurysm during intracranial aneurysmal coiling: A dunk shot technique

1 Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Aichi, Japan
2 Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi, Japan
3 Neuroendovascular Therapy Center; Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi, Japan

Correspondence Address:
Dr. Tomotaka Ohshima
Neuroendovascular Therapy Center, Aichi Medical University, 1-1 Yazakokarimatoa, Nagakute 480-1195, Aichi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_26_21

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Objectives: Various endovascular approaches have been reported for patients with intracranial aneurysms. However, the safety of navigating a microcatheter into the aneurysm remains debatable. In this study, we evaluated a novel method “dunk shot technique,” in which a proximal balloon and a local balloon are used for navigation of a microcatheter into an aneurysm under challenging situations. Materials and Methods: We have reported two cases of unruptured internal carotid artery–superior hypothalamic artery aneurysm. An 8-F balloon-attached catheter was used as the guiding catheter. A local balloon catheter for neck remodeling and a microcatheter for coil insertion were navigated around the aneurysmal neck region. When it seemed difficult to navigate a microcatheter into an aneurysm, both the guiding balloon and a local balloon catheter were used for assistance. After inflation of the guiding balloon, the local balloon was inflated partially to negotiate the tip of the microcatheter. Results: The uncontrollable tip of the microcatheter could be intentionally moved by the local balloon. Conclusions: We evaluated the effectiveness of the balloon-assisted technique for the navigation of a microcatheter in cases with challenging anatomy. A little bit of direct effect to the tip of the microcatheter by a local balloon could produce effective outcomes under the proximal flow arrest.

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