Caption: Figure 3: A microcatheter (EV3 Marathon) was navigated coaxially into the parent artery
over a guidewire (EV3 Silver Speed) to reach the pseudoaneurysm.
Our case illustrates a unique requirement among embolization targets: the dissection of the target tumor from the parent artery
used to embolize it.
Stroke can occur because the parent artery
feeding the aneurysm may become occluded.
This allows aneurysms to be excluded from the circulation, whilst preserving blood flow through the parent artery
. To date we have used this method to treat more than 200 patients, many of whom were considered unsuitable surgical candidates for various reasons, including age.
The dual-balloon anti-reflux microcatheter can be placed in the adjacent parent artery
(e.g., right hepatic artery) and the chemoembolic infused laterally, into the perpendicular branch, such that the usual superselective segmental or subsegmental catheterization is not needed.
First because of sparse and delicate collateral supply to the lateral striatal tissues, sparing of the parent artery
is crucial to avoid symptomatic postoperative infarctions.
PCA aneurysms can be treated with proximal occlusion of the parent artery
, excision of aneurysm, or wrapping .
In our study, most (66.7%) of the RIMA grafts were used in-situ, being dissected as a pedicle from the parent artery
with only a few free RIMA grafts employed.