J Cerebrovasc Endovasc Neurosurg.  2016 Dec;18(4):363-368. 10.7461/jcen.2016.18.4.363.

The Interference Phenomenon of Microcatheters in the Jailing Treatment for Internal Carotid Artery Side Wall Aneurysms with an Open Cell Stent System

• Yoo M
• Jin SC
• Kim SH
• Choi BS
• Kim HY
• Lee S
• Kim ST
• Jeong HW

• KMID: 2367327
• DOI: http://doi.org/10.7461/jcen.2016.18.4.363

Abstract

OBJECTIVE
Excelsior XT-27 (Stryker Neurovascular, Fremont, CA, USA) or Rebar 27 (eV3 Covidien, Irvine, CA, USA) microcatheters have recently been used to overcome the limitations of the Renegade Hi-Flo microcatheter such as interference between two microcatheters (one for stent delivery and the other for cerebral aneurysm coiling) during the jailing technique. We evaluated differences and influential factors related to the interference phenomenon according to these two microcatheters group.
MATERIALS AND METHODS
Between June 2011 and September 2013, the jailing technique was applied to 94 internal cerebral artery (ICA) aneurysms. The jailing technique with the Neuroform EZ stent system was performed using Renegade (n = 22), Rebar (n = 35), and XT-27 microcatheters (n = 37). In the Renegade Hi-Flo microcatheter group, the jailing technique was successful in 19/22 patients (86.4%) and interference between the two microcatheters occurred in 6/21 patients (28.6%). In the Rebar and XT-27 microcatheter group, the jailing technique was successful in 71/72 patients (98.6%) and interference between the two microcatheters occurred in 1/72 patients (1.4%).
RESULTS
There was a significant difference in the interference between the two delivered microcatheters group (p-value < 0.000) and the carotid siphon angle (p-value: 0.004) in the univariate analysis. In the multiple logistic regression analysis, the Rebar and XT-27 microcatheter group (odds ratio [OD] [95% confidence interval (CI)]; 31.277 [3.138-311.729], p-value: 0.003) and the carotid siphon angle (OD [95%CI]; 0.959 [0.922-0.997], p-value: 0.035) were found to be influential factors in the interference phenomenon.
CONCLUSION
The Rebar 27 and XT-27 microcatheters were more successful and exhibited less interference between the two microcatheters than the Renegade Hi-Flo microcatheter.

Keyword

ICA; Open cell stent; Side wall aneurysm; Microcatheter

MeSH Terms

Aneurysm*
Carotid Artery, Internal*
Cerebral Arteries
Humans
Intracranial Aneurysm
Logistic Models
Stents*

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