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Undulating microcatheter tip motion with respiratory cycle during intracranial aneurysm embolization: description of a case and strategy for its mitigation
  1. James X Chen1,
  2. Allan Gottschalk2,
  3. Sudhir Kathuria1,3,
  4. Dheeraj Gandhi1,3
  1. 1Division of Interventional Neuroradiology, Russell H Morgan Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland, USA
  2. 2Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA
  3. 3Departments of Neurosurgery and Neurology, Johns Hopkins Hospital, Baltimore, Maryland, USA
  1. Correspondence to Dr Dheeraj Gandhi, Department of Radiology, Nelson Building Room B-100, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, Maryland 21287, USA; dgandhi2{at}


The present report describes a technique for mitigating respiration-related microcatheter motion during endovascular aneurysm treatment by modulating ventilator settings. A rare phenomenon of microcatheter tip movement related to respiration is demonstrated. An adjustment of tidal volume and respiratory rate reduced the degree of inspiratory vessel elongation and stabilized the microcatheter position, allowing for safer, more precise coil deployment. This maneuver can easily be applied to other endovascular procedures for which aberrant microcatheter motion must be minimized.

  • Aneurysm
  • angiography
  • spine
  • eye
  • malignant
  • MRI
  • CT
  • spinal cord
  • technique
  • complication
  • catheter
  • balloon
  • thrombolysis
  • stroke
  • stent
  • intervention
  • hemorrhage
  • embolic
  • coil
  • atherosclerosis
  • meninges
  • posterior fossa
  • subarachnoid
  • thrombectomy
  • history

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  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Institutional Review Board.

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