Maeda Kazushi, Otsuji Ryosuke, Uno Junji, Gi Hidefuku
Department of Neurosurgery, Baba Memorial Hospital, Sakai, Osaka, Japan.
BMJ Case Rep. 2018 Aug 27;2018:bcr-2018-224864. doi: 10.1136/bcr-2018-224864.
We describe here a novel yet very simple technique, called microguidewire-assist (MGA) manoeuvre, for coil embolisation of unruptured intracranial aneurysms. A 79-year-old woman with a small, broad-necked middle cerebral artery (MCA) bifurcation aneurysm that incorporated the orifice of the acute-angled M2 superior trunk underwent coil embolisation. Since the balloon assist technique was not feasible, we inserted and retained only the microguidewire through M1 to the M2 superior trunk; subsequently, with appropriate use of the microguidewire, coil embolisation was completed. The MGA manoeuvre resulted in slight vessel straightening and subsequent changes in the angulation of the aneurysmal neck, with which stable placement of the platinum coil was successfully accomplished. For coil embolisation of small, broad-necked MCA aneurysms that partially straddle the M2 trunk, this manoeuvre might provide an effective therapeutic alternative if other techniques are not feasible.
我们在此描述一种新颖且非常简单的技术，称为微导丝辅助（MGA）操作，用于未破裂颅内动脉瘤的弹簧圈栓塞。一名79岁女性，患有一个小的、宽颈的大脑中动脉（MCA）分叉动脉瘤，该动脉瘤包含锐角M2上干的开口，接受了弹簧圈栓塞。由于球囊辅助技术不可行，我们仅将微导丝通过M1插入并保留至M2上干；随后，通过适当使用微导丝，完成了弹簧圈栓塞。MGA操作导致血管轻微变直以及随后动脉瘤颈部角度的改变，借此成功实现了铂弹簧圈的稳定放置。对于部分跨越M2干的小的、宽颈MCA动脉瘤的弹簧圈栓塞，如果其他技术不可行，这种操作可能提供一种有效的治疗选择。
