Double Wire Technique for Stenting Tortuous Cerebral Vessels

The failure to catheterize distal vessels may preclude optimal endovascular intervention. We present a double wire technique to facilitate the selective placement of catheters into tortuous vasculature when a single wire and catheter technique does not suffice. A wide necked middle cerebral artery (...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2012-11, Vol.21 (8), p.905.e7-905.e10
Main Authors: Lopes, Demetrius Klee, MD, Johnson, Andrew Kelly, MD, Schreiner, Cristian Ariel, MBA
Format: Article
Language:English
Subjects:
Aged
Aneurysm
Angiography, Digital Subtraction
Cardiovascular
catheter
cerebral
Cerebral Angiography - methods
double wire
endovascular
Endovascular Procedures - instrumentation
Female
Humans
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - therapy
middle cerebral artery
Middle Cerebral Artery - diagnostic imaging
Neurology
Radiography, Interventional
stent
Stents
Treatment Outcome
Vascular Access Devices
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Description
Summary:The failure to catheterize distal vessels may preclude optimal endovascular intervention. We present a double wire technique to facilitate the selective placement of catheters into tortuous vasculature when a single wire and catheter technique does not suffice. A wide necked middle cerebral artery (MCA) aneurysm incorporated the origin of the inferior MCA trunk, and despite successful passage of a wire into the distal MCA, the catheter could not be advanced beyond 2 sharp turns at the inferior trunk origin. A second wire was passed through the catheter into the inferior trunk providing adequate stability for advancement of the catheter into the vessel. The distal vessel was successfully catheterized and a stent was placed without complication. The double wire technique may allow the passage of catheters into vessels that are otherwise inaccessible because of tortuosity.
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2011.06.002