Endovascular Treatment of Ruptured Broad-Necked Intracranial Aneurysms with Double Microcatheter Technique: Case Series with Brief Review of Literature.

Objective  Treatment of ruptured broad-necked intracranial aneurysms by endovascular therapy is technically burdensome. It is commonly treated with stent- and balloon-assisted coils embolization. The aim of this study was to evaluate clinical and radiological outcomes following double micro-catheter (MC) technique. Materials and Methods  A retrospective study was done on 16 broad-necked (neck diameter ≥ 4 mm and dome-to-neck ratio < 2) ruptured intracranial aneurysms in 16 patients treated with double MC technique at our center between December 2021 and December 2023. Clinical outcome was evaluated by modified Rankin Score, postcoiling radiological outcome was evaluated by Raymond-Roy occlusion grade, and treatment-related complications were assessed. Results  There were 16 patients, 9 females and 7 males; with a mean age of 51.3 years (35-70 years). All the patients underwent dual MC coils embolization for all aneurysms. Raymond-Roy occlusion class I was achieved in 81.3% (13) cases and Raymond-Roy class II was achieved in 18.7% (3) cases immediately after the procedure. There were no serious postprocedure-related complications or recanalization of the aneurysm at the mean follow-up of 4.8 months (range 2-10 months). Conclusion  Our study presents the safety and effectiveness of double MC system for treating ruptured broad-necked intracranial aneurysm. Large numbers of studies with longer follow-up period are required to secure validity of double MC technique.