{"title":"New embolization technique for intracranial vascular disease with the assistance of an Apollo microcatheter","authors":"Jinlu Yu","doi":"10.1016/j.radcr.2024.10.068","DOIUrl":null,"url":null,"abstract":"<div><div>It is difficult to access small and remote intracranial vascular lesions when using routine coil-delivery microcatheters. A thin Apollo microcatheter can access these vascular lesions. The Apollo microcatheter is intended to reduce the risk of catheter entrapment during the deployment of Onyx due to the detachable tip; furthermore, the Apollo microcatheter with a 3 cm detachable tip has 2 markers. X-ray imaging revealed that the marker on the push lever of the coil matched the proximal marker on the Apollo microcatheter. Therefore, it can replace routine coil-delivery microcatheters to deliver certain coils and then cast Onyx following coiling. The technique has rarely been reported. Patient 1 was a 59-year-old male with a ruptured aneurysm at the branch of posterior cerebral artery. The aneurysm was coiled with a Jasper ®SS-10 coil via an Apollo microcatheter with a 3 cm detachable tip. Then, Onyx-18 was used to obliterate the aneurysm. The patient recovered well after the procedure. Patient 2 was a 51-year-old male with a brain arteriovenous malformation (BAVM). There was a fistulous structure in the nidus. The Apollo microcatheter with a 3 cm detachable tip was used to reach and coil the fistulous structure with a Jasper ®SS-10 coil. Then, Onyx-18 was used to partially embolize the BAVM. The patient recovered well after the procedure. Therefore, the use of an Apollo microcatheter with a 3 cm detachable tip to deliver both coils and Onyx represents a new approach for treating intracranial vascular diseases when routine coil-delivery microcatheters cannot reach the lesions.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiology Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1930043324011762","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
It is difficult to access small and remote intracranial vascular lesions when using routine coil-delivery microcatheters. A thin Apollo microcatheter can access these vascular lesions. The Apollo microcatheter is intended to reduce the risk of catheter entrapment during the deployment of Onyx due to the detachable tip; furthermore, the Apollo microcatheter with a 3 cm detachable tip has 2 markers. X-ray imaging revealed that the marker on the push lever of the coil matched the proximal marker on the Apollo microcatheter. Therefore, it can replace routine coil-delivery microcatheters to deliver certain coils and then cast Onyx following coiling. The technique has rarely been reported. Patient 1 was a 59-year-old male with a ruptured aneurysm at the branch of posterior cerebral artery. The aneurysm was coiled with a Jasper ®SS-10 coil via an Apollo microcatheter with a 3 cm detachable tip. Then, Onyx-18 was used to obliterate the aneurysm. The patient recovered well after the procedure. Patient 2 was a 51-year-old male with a brain arteriovenous malformation (BAVM). There was a fistulous structure in the nidus. The Apollo microcatheter with a 3 cm detachable tip was used to reach and coil the fistulous structure with a Jasper ®SS-10 coil. Then, Onyx-18 was used to partially embolize the BAVM. The patient recovered well after the procedure. Therefore, the use of an Apollo microcatheter with a 3 cm detachable tip to deliver both coils and Onyx represents a new approach for treating intracranial vascular diseases when routine coil-delivery microcatheters cannot reach the lesions.
期刊介绍:
The content of this journal is exclusively case reports that feature diagnostic imaging. Categories in which case reports can be placed include the musculoskeletal system, spine, central nervous system, head and neck, cardiovascular, chest, gastrointestinal, genitourinary, multisystem, pediatric, emergency, women''s imaging, oncologic, normal variants, medical devices, foreign bodies, interventional radiology, nuclear medicine, molecular imaging, ultrasonography, imaging artifacts, forensic, anthropological, and medical-legal. Articles must be well-documented and include a review of the appropriate literature.