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Case report
The wire anchor loop traction (WALT) maneuver
  1. Khaled Effendi1,
  2. Raphael Hillel Sacho1,
  3. François Belzile2,
  4. Thomas R Marotta1
  1. 1Diagnostic and Therapeutic Neuroradiology, St Michael's Hospital, Toronto, Canada
  2. 2Division of Neuroradiology, Department of Medical Imaging, Centre Hospitalier Universitaire de Sherbrooke, University of Sherbrooke, Sherbrook, Canada
  1. Correspondence to Dr Thomas R Marotta, Diagnostic and Therapeutic Neuroradiology, St Michael's Hospital, Toronto M5B 1W8, Canada; marottat{at}smh.ca

Abstract

Crossing the neck of large complex intracranial aneurysms for the purposes of stent deployment can be challenging using standard over the wire techniques. We describe a novel yet simple technique for straightening out the loop formed within a large intracranial aneurysm, which is often required in order to cross the aneurysm neck into the distal branch. Both the microcatheter and microwire are initially introduced into the distal vasculature, followed by withdrawal of the microwire to a point parallel to the distal exiting branch. The microcatheter and microwire are then gently withdrawn and a series of maneuvers to gradually reduce the loop is performed, obviating the need for distal purchase in the form of a stent, balloon, or coil, which have previously been described to maintain distal purchase.

  • Aneurysm
  • Catheter
  • guidewire
  • Stent
  • Technique

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