Endovascular treatment of very small aneurysms is technically difficult, although recent advances with coils, microcatheters and adjunctive techniques such as balloon- or stent-assisted coiling have improved the outcomes. The microangiographic fluoroscope (MAF) is a new high-resolution x-ray detector developed for neurointerventional procedures in which superior resolution is required within a small field of view. We report the successful coil embolization of a very small ruptured anterior communicating artery aneurysm using the MAF technique. The use of the MAF facilitated the precision of the coiling procedure and was helpful in preventing catheter- and coil-related intraprocedural complications.
- Intracranial aneurysm
- microangiographic fluoroscope
- CT angiography
- CT perfusion
- flow diverter
- cranial nerve
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Funding National Institutes of Health (NIH) grants R01NS43924 and R01EB002873 provided for this and other related research.
Competing interests CNI and AJ receive research support from NIH grants R01NS43924 and R01EB002873. EIL receives research grant support, other research support (devices) and honoraria from Boston Scientific (Boston Scientific's neurovascular business has been acquired by Stryker) and research support from Codman & Shurtleff and ev3/Covidien Vascular Therapies; has ownership interests in Intratech Medical Ltd and Mynx/Access Closure; serves as a consultant on the board of Scientific Advisors to Codman & Shurtleff; serves as a consultant per project and/or per hour for Codman & Shurtleff, ev3/Covidien Vascular Therapies and TheraSyn Sensors; and receives fees for carotid stent training from Abbott Vascular and ev3/Covidien Vascular Therapies. EIL receives no consulting salary arrangements; all consulting is per project and/or per hour. SR receives research support from NIH grants R01NS43924 and R01EB002873 (principal investigator) and equipment from Toshiba Corporation. AHS receives research support from NIH grants R01NS43924 and R01EB002873 (co-investigator), research grants from the National Institutes of Health (co-principal investigator: NINDS 1R01NS064592-01A1) and the University at Buffalo (Research Development Award); holds financial interests in Hotspur, Intratech Medical, StimSox and Valor Medical; serves as a consultant to Codman & Shurtleff, Concentric Medical, ev3/Covidien Vascular Therapies, GuidePoint Global Consulting and Penumbra; belongs to the speakers' bureaus of Codman & Shurtleff and Genentech; serves on an advisory board for Codman & Shurtleff; and has received honoraria from American Association of Neurological Surgeons' courses, an Emergency Medicine Conference, Genentech, Neocure Group and from Abbott Vascular and Codman & Shurtleff for training other neurointerventionists in carotid stenting and for training physicians in endovascular stenting for aneurysms. AHS receives no consulting salary arrangements; all consulting is per project and/or per hour. PK and PY have no financial relationships.
Ethics approval The Health Sciences Institutional Review Board, University at Buffalo, State University of New York (Buffalo, New York, USA) does not require approval in conjunction with a case report/technical note. However, the use of microangiographic fluoroscopy was approved by the board. The principles of the Declaration of Helsinki were followed.
Provenance and peer review Not commissioned; externally peer reviewed.