Introduction Cerebral aneurysm coiling is a complex procedure that requires precise placement of the microcatheter into the aneurysm.
Aim of Study We examined the use of a new technique called the Wireless Microcatheter Pulled Back Technique (the Reverse Parking Technique), to improve the stability and safety of microcatheter placement.
Methods From July 1, 2022 to December 31, 2022, a total of 76 cases at a tertiary hospital underwent cerebral aneurysm coiling, with 51 cases utilizing the Reverse Parking Technique. The technique involves using a roadmap technique to guide the microcatheter over the microwire and into position within the parent vessel adjacent to the aneurysm, slightly passing the aneurysm. The microwire is then pulled into the microcatheter, and any slack or redundancy in the microcatheter is removed by gently pulling back on it. The microcatheter is slowly pulled back, allowing the tip to flip into the aneurysm..
Results Of the 51 cases that used the Reverse Parking Technique, 46 cases (90%) were successful, with no intraprocedural aneurysm perforation. In 5 cases, the technique failed, and the push technique was used instead. In one case, a thromboembolic complication occurred, but there was no neurological sequela. Two cases experienced unexpected premature microcatheter kicks back, but they were repositioned into the aneurysm relatively easily.
Conclusion The Reverse Parking Technique is a safe and reliable method for placing the microcatheter inside the aneurysm, particularly for small and ruptured aneurysms. It may help improve the success rate and reduce complications during cerebral aneurysm coiling procedures.
Disclosure of Interest Nothing to disclose
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