Intracranial aneurysm with poor topography embolized by a coil guiding catheterization technique

Intracranial aneurysms with poor topography are still difficult and dangerous to be catheterized during endovascular procedures. Here we report a novel coil guiding catheterization technique which could be safe and helpful. Seven aneurysms of 5 cases were embolized with the novel coil guiding catheterization technique in Zhongshan Hospital, Fudan University, from January 2017 to March 2019. All the aneurysms were with poor topography for endovascular embolization. One of the aneurysms was in the posterior communicating segment of internal carotid artery (ICA), three in the ophthalmic segment of ICA, and one in the posterior cerebral artery. Two of the cases had multiple aneurysms. All the aneurysms were catheterized by coil guiding technique and embolized. All the aneurysms were catheterized successfully and safely. The aneurysms embolization results were as follows: Raymond Class 1 occlusion was achieved in 4 aneurysms, Class 2 occlusion in 1, Class 3 occlusion in 2 immediately after the procedure. Follow-up imaging demonstrated all the aneurysms achieved total occlusion. There was no aneurysm re-rupture or patient death. The results indicated that the technique has good safety and effectiveness, with a high rate of technical success and a low rate of periprocedural complications in the reported cases. Thus, appling coil guiding aneurysm catheterization could be considered as a safe and effective method, especially for aneurysms with poor topography.