New embolization technique for intracranial vascular disease with the assistance of an Apollo microcatheter

Q4 Medicine Radiology Case Reports Pub Date : 2024-10-31 DOI:10.1016/j.radcr.2024.10.068
Jinlu Yu
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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.
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借助阿波罗微导管治疗颅内血管疾病的新栓塞技术
使用常规的线圈输送微导管很难进入微小和偏远的颅内血管病变部位。纤细的阿波罗微导管可以进入这些血管病灶。由于阿波罗微导管的顶端可拆卸,其目的是降低在部署Onyx时导管被卡住的风险;此外,阿波罗微导管的顶端为3厘米,可拆卸,有2个标记。X 射线成像显示,线圈推杆上的标记与阿波罗微导管上的近端标记一致。因此,它可以取代常规的线圈输送微导管来输送某些线圈,然后在线圈输送后铸造Onyx。该技术鲜有报道。患者 1 是一名 59 岁的男性,大脑后动脉分支动脉瘤破裂。使用 Jasper ®SS-10 线圈通过带有 3 厘米可拆卸尖端的阿波罗微导管对动脉瘤进行了盘绕。然后,使用Onyx-18堵塞动脉瘤。患者术后恢复良好。患者2是一名51岁的男性,患有脑动静脉畸形(BAVM)。瘤巢内有一个瘘管结构。使用带有 3 厘米可拆卸尖端的 Apollo 微导管到达瘘管结构,并用 Jasper ®SS-10 线圈进行盘绕。然后,使用 Onyx-18 对 BAVM 进行部分栓塞。术后患者恢复良好。因此,当常规线圈输送微导管无法到达病变部位时,使用带有3厘米可拆卸尖端的阿波罗微导管同时输送线圈和Onyx是治疗颅内血管疾病的一种新方法。
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来源期刊
Radiology Case Reports
Radiology Case Reports Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
1.10
自引率
0.00%
发文量
1074
审稿时长
30 days
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.
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