Combined microcatheter and guidewire technique in endovascular coiling of a wide-neck anterior communicating artery aneurysm: A case report.

Wide-necked anterior communicating artery (ACoA) aneurysms pose challenges for endovascular coiling due to the risk of coil protrusion. This case report describes a new endovascular technique for managing ruptured wide-necked ACoA aneurysms, addressing the risk of coil protrusion during embolization. This method employs a combined microcatheter and guidewire-assisted embolization method, enabling coil deployment without needing adjunctive devices such as stents or balloons. Compared to traditional approaches, this technique avoids stent-related complications, preserves cerebral blood flow and minimizes procedural complexity. It may represent a safe and effective alternative in selected cases, with stent placement retained as a bailout strategy when necessary.