ABSTRACT
For an effective and durable occlusion of cerebral aneurysm, the aneurysmal sac should be packed by detachable coils as densely as technically possible. Navigating microcatheters, coil framing, and packing of the sac are the major technical steps of aneurismal embolization. There are several additional techniques and devices for dealing with wide-necked aneurysms. This paper reviews and describes various techniques for safe navigation of microcatheters including tip shaping, selection of the shapes for initial coil framing, selection of coil sizes techniques for packing, and techniques of balloon- or stent-assisted coiling for embolization of wide-necked lesions.
Subject(s)
Aneurysm , Embolization, Therapeutic , Intracranial AneurysmABSTRACT
After development of Guglielmi detachable coil (GDC), endovascular technique revolutionized the management of intracranial aneurysms and became one of the primary therapeutic options even in an acutely ruptured anterior circulation aneurysm. With this detachable coil system, the aneurismal sac can be packed without significant manipulation and occluded safely without craniotomy. Detachable coil systems with various detachment mechanisms, coil shapes and surface modifications were developed with different characteristics and are available for the practice. Indications, technical principles, post-treatment management, result, and complications of endovascular treatment of cerebral aneurysms are reviewed and discussed.