Use of Triple Microcatheters for Endovascular Treatment of Wide-Necked XXXX : A Single Center Experience.

@entity1 @entity439 @entity438
OBJECTIVE: The dual microcatheter technique is common practice for coil embolization of a wide-necked @entity439 , due to safety and efficacy. However, technical limitations of some complex configurations may necessitate additional microcatheters to bolster coil stability, compact the coil, or for protection. Described herein is a triple microcatheter technique for endovascular management of wide-necked @entity438 . MATERIALS AND METHODS: Data accruing prospectively between January 2006 and October 2014 on simultaneously executed triple microcatheter coil embolization procedures done in 38 @entity439 were reviewed. Clinical and morphological outcomes were assessed, with emphasis on technical aspects of treatment. RESULTS: The triple microcatheter technique was successfully applied to all 38 @entity439 , involving the posterior communicating artery (n = 13), the middle cerebral artery (n = 10), the basilar tip (n = 7), the anterior cerebral artery (n = 5), and the internal carotid artery (n = 3). Stent protection was added in four @entity1 and balloon remodeling in one. Dual microcatheters (n = 24) were usually deployed to deliver the coil within sacs of @entity439 , with the additional microcatheter used for protection. Otherwise, triple microcatheters were deployed for coil delivery (n = 11) or coils were delivered via a single microcatheter, with dual microcatheters deployed for protection (n = 3). Successful occlusion of @entity439 was achieved in 89.5% of cases, with no procedure-related morbidity or mortality. Stable occlusion was maintained in 72.2% (26/36) of the @entity439 at the final follow-up (mean interval, 30.2    22.7 months). CONCLUSION: The outcomes of this limited study suggest that the triple microcatheter technique may be an effective and safe therapeutic option for wide-necked @entity439 , using technical strategies tailored to complex angio-anatomic configurations.
