Three-Dimensional (3D) Microcatheter Shaping Using Touch Screen Devices for Cerebral Aneurysm Coil Embolization

World Neurosurg. 2024 Feb:182:e823-e828. doi: 10.1016/j.wneu.2023.12.053. Epub 2023 Dec 13.

Abstract

Objective: In cerebral aneurysm coil embolization, proper microcatheter shaping is crucial to reduce complications and achieve sufficient embolization. Shaping a microcatheter in 3 dimensions (3D) is often required but can be challenging. We assessed the usefulness of a novel shaping on screen (SOS) method that displays real-size 3D rotational angiography (RA) images on a touch screen device during cerebral aneurysm embolization to facilitate 3D microcatheter shaping.

Methods: In this study, 18 patients with cerebral aneurysm treated with this technique were included. Real-size 3D-RA images obtained during the embolization procedure were displayed on the touch screen device, which allowed for real-time manipulation. The shape of the microcatheter was adjusted to conform to the curvature of the vessel by swiping the touch screen device and bending the mandrel accordingly. We assessed the clinical and angiographic results, along with the accuracy and stability of the microcatheter.

Results: No procedure-related complications were observed. The mean packing density was 41% ± 12%. In all but 1 case, microcatheters were inserted into the aneurysms without guidewire assistance. After coiling, all microcatheter forms were stable.

Conclusions: Three-dimensional (3D) microcatheter shaping using touch screen devices during cerebral aneurysm coil embolization may be simple and safe and can achieve high packing density of aneurysms.

Keywords: Cerebral aneurysm; Embolization; Microcatheter; Shaping.

MeSH terms

  • Blood Vessel Prosthesis
  • Catheters
  • Cerebral Angiography / methods
  • Embolization, Therapeutic* / methods
  • Humans
  • Imaging, Three-Dimensional
  • Intracranial Aneurysm* / diagnostic imaging
  • Intracranial Aneurysm* / therapy