Retrograde stenting through anterior communicating artery in coil embolization of the posterior communicating artery aneurysm: contralateral approach |
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Authors: | Hyon Jo Kwon Young Dae Cho Jeong Wook Lim Hyeon-Song Koh Dong Hyun Yoo Hyun-Seung Kang Moon Hee Han |
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Affiliation: | 1. Department of Neurosurgery, Regional Cerebrovascular Center, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea;2. Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea;3. Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea;4. Department of Radiology, Veterans Health Service Medical Center, Seoul, Korea |
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Abstract: | During coil embolization of wide-necked posterior communicating artery (PcomA) aneurysms, stent assistance is sometimes limited if PcomA is acutely angled at its origins from saccular neck. Herein, we present two instances where retrograde stenting was used for coil embolization of PcomA aneurysms. Both procedures involved a contralateral approach via anterior communicating artery (AcomA). To achieve this, the stent-delivery microcatheter was inserted retrograde from contralateral to ipsilateral internal carotid artery (ICA) across AcomA, arriving at ipsilateral PcomA. A separate microcatheter, passed through ipsilateral ICA, was then used to select the aneurysm sac for coil delivery. Coil embolization ultimately took place under protection of a horizontally placed stent extending from PcomA to terminal ICA. Each aneurysm was properly coiled and occluded, without procedural complications. This stenting technique is a reasonable option, offering a means of strategic coil embolization in wide-necked PcomA aneurysms and providing complete neck coverage through contralateral access. |
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Keywords: | aneurysm coil embolization posterior communicating artery stent |
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