Endovascular Management of the Wide-neck Aneurysms: the Applications of the Coils and Catheter / 신경중재치료의학

ABSTRACT

The endovascular treatment of aneurysms with wide-neck or the incorporated branch can be technically very challenging. Various neck protecting devices, such as temporary balloons or self-expanding stents are effective for management of the wide-neck aneurysm. However, these devices are not amenable to successful management of aneurysms with unfavorable configurations, because the introduction of additional devices into small intracranial vessels is technically demanding. Without the support of these neck protecting devices, the use of three-dimensional (3D) coils or coil delivery technique with the application of microcatheter can help to overcome the unfavorable configuration of the aneurysm. This article presents 3D coils, double catheter method, and catheter-assisted method for coil embolization of the wide-neck aneurysm independently with neck protecting device. These methods are considered as viable alternatives for management of wide-neck aneurysms. To make the strategy of the endovascular treatment of the wide-neck aneurysm, neurointerventionists should consider the aneurysm configuration, relationship between the aneurysm and parent artery, the presence of incorporated branch, proximal approach route, technical availability, the risk of thromboembolic complications, and antiplatelet therapy.