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Placement of an intrasaccular flow diverter in an intracranial sidewall aneurysm using the Bendit articulating microcatheter
  1. Alex Devarajan,
  2. Mais Al-Kawaz,
  3. Brian Giovanni,
  4. Halima Tabani,
  5. Tomoyoshi Shigematsu,
  6. Johanna T Fifi
  1. Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  1. Correspondence to Alex Devarajan; alex.devarajan{at}icahn.mssm.edu

Abstract

Intrasaccular flow diversion is a new endovascular option for managing unruptured intracranial aneurysms.1–6 However, catheter ejection can occur during placement of an intrasaccular flow diverter, especially in tortuous vasculature that creates unfavorable angles between the aneurysm neck and the parent vessel.5 The Bendit steerable microcatheter (Bendit Technologies, Petah Tikva, Israel) can dynamically change its tip angle and may mitigate these placement concerns.7–9 Here, we report the placement of an intrasaccular flow diverter for the treatment of an unruptured internal carotid artery sidewall aneurysm at an unfavorable neck angle using the Bendit microcatheter (video 1). The Bendit was navigated around the 180° turn of the carotid siphon and held a stable position during device delivery. The device was sequentially deployed as the Bendit was progressively straightened and was successfully placed within the aneurysm. No neurological complications were experienced and the patient was asymptomatic on follow-up 3 months later.

Video 1 Placement of an intrasaccular flow diverter in an intracranial sidewall aneurysm using the Bendit articulating microcatheter.
  • Aneurysm
  • Flow Diverter
  • Catheter
  • Device
  • guidewire

https://doi.org/10.1136/jnis-2023-020529

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    Footnotes

    • X @AlexDevarajan, @Mais_Alk

    • Contributors Conception and design: AD, JTF. Interpretation and analysis of manuscript: AD, JTF. Writing, editing, and approval of technical video: AD, MAK, BG, HT, TS, JTF. Study supervision: JTF.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests JTF: Leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid: Society of NeuroInterventional Surgery Board of Directors; stock of stock options: ownership of Bendit Technologies stock.

    • Provenance and peer review Not commissioned; externally peer reviewed.