微导丝成袢技术在小角度大脑前动脉插管中的应用

目的 :报道采用微导丝成袢技术对一些小角度大脑前动脉 (ACA)插管的经验。方法 :把微导丝头端塑成弯度较大的倒置伞柄状 ,当其抵达颈内动脉 (ICA)的虹吸段时 ,把其顶在ICA的壁上并稍用力向前推微导管 ,使微导丝形成一个U型袢 ,并顺势把该袢送入大脑中动脉 (MCA)的M1 段。随后回拉微导丝使其勾住A1 段开口 ,不断后撤微导丝 ,使其的头端不断进入A1 ,最后送入微导管。结果 :12例患者均采用该技术成功地对ACA进行了超选择性插管 ,闭塞了动脉瘤。技术成功率 10 0 %,无并发症。结论 :当常规方法失败后 ,微导丝成袢技术十分适合于小角度ACA的插管

Microguidewire looping technique for superselective catheterization of the acute-angled anterior cerebral artery

Objective:To report the experience with the microguidewire looping technique for superselective catheterization of the acute angled anterior cerebral artery (ACA).Methods:Shape the microguidewire into a reversed umbrella hub shape.When the microguidewire advanced into the carotid siphon,push the microguidewire against into the vessel wall allowing it to elongate into a U shape loop.Advancing the microguidewire into the middle cerebral artery until the tip of microguidewire was distal to the origin of the ACA.Withdraw the microguidewire,the tip will advance into the ACA.Slowly withdraw the microguidewire to reduce the loop,the microguidewire will be advanced further into the ACA spontaneously.Then push the microcatheter into the ACA over the microguidewire.Results:Twelve patients with acute angled ACA were successfully catheterized.All the cerebral aneurysms were embolized successfully.Technical success rate is 100%.No complication was found.Conclusion:Microguidewire looping technique is a feasible method for superselective catheterization of the acute angled ACA when the regular approach is failed.