Aneurysm Coil Embolization Using a 1.5-Fr Distal Outer Diameter Microcatheter
A 48-year-old female with a strong history of familial cerebral aneurysms was found to have a 4 mm saccular aneurysm with a broad neck at the right ICA terminus on a screening MRA of the brain. The patient was consented for an elective stent-assisted coil embolization of the aneurysm () given the family history a ruptured cerebral aneurysms and patient preference. On the day of the procedure, the right common carotid artery was selected with a 6-Fr Neuron guide catheter through a right common femoral artery access. A 4.5 × 20 mm Neuroform EZ stent (Stryker, Kalamazoo, MI, USA) was deployed from the A1 segment into the ICA. A Marathon microcatheter was used to catheterize the ICA terminus aneurysm through the stent and a 3 mm × 6 cm and 2 mm × 4 cm Target Ultrasoft coils (Stryker, Kalamazoo, MI, USA) were deployed through the Marathon catheter without complication. During deployment of each coil, the RHV and thus continuous flush was temporally removed to accommodate the Styrker electrolytic detachment device (). After the coils were detached from the pusher wire, the electrolytic detachment device was removed and the RHV was replaced restoring the continuous flush before the pusher wire was withdrawn from the catheter to avoid clot formation within the microcatheter. The patient tolerated the procedure well and later discharged home neurologically intact.