Pigtail Catheter Assistance in Guiding Catheter Navigation for Transradial Access for Embolization of Anterior Circulation Aneurysms.

Abstract

Background: The effect and safety of pigtail catheter assistance in navigating the guiding catheter for embolization of anterior circulation aneurysms through the transradial access are unknown.

Aims: This study was to evaluate the effect and safety of pigtail catheter assistance in navigating the guiding catheter for embolization of anterior circulation aneurysms through the transradial access.

Methods: Seventy patients with intracranial aneurysms treated with endovascular embolization were retrospectively enrolled. The clinical, endovascular treatment and follow-up data were analyzed.

Results: There were 70 aneurysms, including 47 (67.1% or 47/70) unruptured aneurysms and 23 (32.9% or 23/70) ruptured ones. The surgery was successful in 68 (97.1% or 68/70) patients, with a failure in two (2.9% or 2/70) patients. A 6 F guiding catheter was used in 28 (40% or 28/70) patients, and a 6 F intermediate catheter in 42 (60% or 42/70). Stent-assisted coiling was conducted in 50 (71.4% or 50/70) patients, and coiling alone in 20 (28.6% or 20/70). Immediately after embolization, complete occlusion was in 56 (80% or 56/70), neck remnant in 12 (17.1% or 12/70), and residual aneurysm sac in 2 (2.9% or 2/70). Periprocedural complications occurred in four (5.7% or 4/70) patients. Six-month angiographic follow-up was performed in 54 (77.1% or 54/70) patients with 54 aneurysms, and the Raymond-Roy aneurysm occlusion classification was complete occlusion in 46 (85.2% or 46/54), neck remnant in 8 (14.8% or 14/54), and residual aneurysm sac in 0, which was not significantly (p = 0.16) different from that immediately after embolization.

Conclusion: The pigtail catheter assistance in guiding catheter navigation for embolizing anterior circulation aneurysms via the transradial access is safe and effective even though further confirmation is required.