TY - JOUR T1 - Republished: The bumper technique for advancing a large profile microcatheter JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - e38 LP - e38 DO - 10.1136/neurintsurg-2016-012872.rep VL - 9 IS - 12 AU - Christopher P Kellner AU - Alexander G Chartrain AU - Claire Schwegel AU - Thomas J Oxley AU - Hazem Shoirah AU - J Mocco Y1 - 2017/12/01 UR - http://jnis.bmj.com/content/9/12/e38.abstract N2 - Operators commonly encounter difficulty maneuvering a microcatheter beyond the distal lip of wide neck aneurysms and aneurysms in challenging locations. Few techniques have been described to guide operators in these particular situations. In this case report of a 56-year-old woman with a 16 mm ophthalmic artery aneurysm, the microcatheter continually snagged the distal aneurysm lip, preventing delivery of a flow diverter into the distal parent vessel. In troubleshooting this obstacle, a second microguidewire was introduced alongside the microcatheter and was used to cover the distal lip of the aneurysm to prevent further snagging. The second guidewire successfully deflected the microcatheter into the distal vessel, a technique that we have aptly dubbed the ‘bumper technique’. ER -