The bumper technique for advancing a large profile microcatheter

BMJ Case Rep. 2017 Mar 1;2017:bcr2016012872. doi: 10.1136/bcr-2016-012872.


Operators commonly encounter difficulty maneuvering a microcatheter beyond the distal lip of wide neck aneurysms and aneurysms in challenging locations. Few techniques have been described to guide operators in these particular situations. In this case report of a 56-year-old woman with a 16 mm ophthalmic artery aneurysm, the microcatheter continually snagged the distal aneurysm lip, preventing delivery of a flow diverter into the distal parent vessel. In troubleshooting this obstacle, a second microguidewire was introduced alongside the microcatheter and was used to cover the distal lip of the aneurysm to prevent further snagging. The second guidewire successfully deflected the microcatheter into the distal vessel, a technique that we have aptly dubbed the 'bumper technique'.

Keywords: Aneurysm; Angiography; Catheter; Flow Diverter; Technique.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm / diagnostic imaging
  • Aneurysm / surgery*
  • Catheterization / instrumentation*
  • Catheterization / methods
  • Endovascular Procedures / methods
  • Female
  • Humans
  • Middle Aged
  • Ophthalmic Artery / diagnostic imaging
  • Ophthalmic Artery / surgery*