A Novel Technique of Safe and Versatile Microguidewire Shaping with Neuroendovascular Therapy: Modified Pigtail Method

Satō, Masaki; Ohshima, Tomotaka; Ishikawa, Kojiro; Goto, Shunsaku; Yamamoto, Taiki; Izumi, Tohru; Nishizawa, Tsutomu; Shimato, Shinji; Kato, Kyozo

doi:10.5797/jnet.tn.2016-0073

Cited by 8 publications

(9 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a previous study, it was reported the usefulness of pigtail shaped of microguidewire as a method to safely guide a microguidewire into a perforator or occluded vessel that is not visible on angiography. 14) This method enables the assessment of thrombus rigidity based on intraoperative changes in the microguidewire shape and may be reflected by thrombectomy procedures. 15) If a CCF develops during endovascular treatment in patients with AIS, as demonstrated in the present case, Fig.…”

Section: Resultsmentioning

confidence: 99%

Carotid Cavernous Fistula during Thrombectomy for Acute Ischemic Stroke: A Case Report

Tsuji

Yoshimura

et al. 2021

JNET

View full text Add to dashboard Cite

Objective We report a rare complication, carotid cavernous fistula (CCF), due to vessel perforation during thrombectomy for acute ischemic stroke (AIS). Case Presentation An 88-year-old woman underwent thrombectomy for left C4 occlusion of the internal carotid artery. There was strong resistance at the medial C4 while the microguidewire was guided distally, and a CCF was found after deploying and retrieving the stent. It was thought to have been caused by perforation due to intracranial atherosclerotic stenosis of the internal carotid artery. Conclusion During thrombectomy for intracranial large vessel occlusion underlying intracranial atherosclerotic stenosis, the risk of vascular injury should be kept in mind.

show abstract

Section: Resultsmentioning

confidence: 99%

Carotid Cavernous Fistula during Thrombectomy for Acute Ischemic Stroke: A Case Report

Tsuji

Yoshimura

et al. 2021

JNET

View full text Add to dashboard Cite

show abstract

“…We used an MGW with a modified pigtail shape to achieve this spiral pattern. [ 6 7 ] The results obtained show that the beanstalk method may be effective for decreasing the ledge effect. The gap between the catheter and the MGW traveling along the exterior of a tortuous vessel decreased in size with the use of this novel technique, compared with the use of a parallel double MGW.…”

Section: Discussionmentioning

confidence: 99%

A novel technique for mitigation of the ledge effect caused by the use of a large-lumen catheter during neurointervention: Beanstalk method

Ohshima

Miyachi

2020

Asian J Neurosurg

Self Cite

View full text Add to dashboard Cite

Navigating a large-caliber catheter into the intracranial artery may generate a “ledge effect,” which disturbs successful neurointervention. Particularly, navigation of a large-lumen aspiration catheter is often required to achieve fast recanalization in acute ischemic stroke cases. Occasionally, the aspirator cannot be passed through the ophthalmic artery origin because of the ledge effect. Here, we report a new technique for mitigation of the ledge effect that involves the use of double micro-guidewires (MGWs). We refer to this technique as the “beanstalk method.” We evaluated the efficacy of our idea using a silicon vascular model. Two 0.014” MGWs are used for navigation of a 0.068” aspirator. After one guidewire is navigated to the distal portion, another MGW is advanced along with the former guidewire, in a spiral fashion, similar to the growth of a beanstalk. The aspirator can then pass with the coaxial double-guidewire, although there is a severe gap in the vessel. We performed an in vitro study to demonstrate the effectiveness of the beanstalk method. The beanstalk method was very useful, even under challenging conditions that did not allow for passage of a conventional coaxial catheter or buddy-wire. The beanstalk method effectively decreases the ledge effect because of the shape of the two wires just ahead of the catheter, which contrasts with the hardness of the spiral wires. In cases involving challenging vasculature, the beanstalk method achieves smoother catheter navigation than the conventional coaxial method or buddy-wire technique.

show abstract

“…Some authors have previously reported that the use of an MPMGW is an extremely safe and versatile method for neuroendovascular procedures. [2][3][4][5][6] The round tip of the wire prevents unintentional entry into the perforating branches or blebs of an aneurysm and reduces the risks of perforation if it enters them erroneously. Moreover, MPMGW is useful in acute thrombectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have reported the use of a modified pigtail-shaped MGW (MPMGW) for various endovascular treatments. [2][3][4][5][6] Although the MPMGW is effective for acute thrombectomy, the manual quick shaping of this wire requires some skills. The common measurement of the round tip is >3.0 mm.…”

Section: Introductionmentioning

confidence: 99%

Initial clinical experience of using a newly designed preshaped microguidewire in acute endovascular thrombectomy

et al. 2020

Self Cite

View full text Add to dashboard Cite

Mechanical thrombectomy has been widely used for the treatment of acute ischemic stroke. During this procedure, operators must navigate the microcatheter with a microguidewire (MGW) into vessels that cannot be visualized on fluoroscopy as rapidly as possible. In this study, we developed a modified pigtail-shaped MGW (MPMGW) for security and controllability. Moreover, the efficacy of the MPMGW for the treatment of acute ischemic stroke was assessed. The MPMGW was designed using 0.014 MGW. Because we created four MPMGWs during a clinical evaluation before the launch in the market, these wires were used in four consecutive patients with acute ischemic stroke in the single institution. The occluded arteries were the basilar artery (n = 1), middle cerebral arteries (M1 and M2, n = 2), and internal carotid artery (n = 1). All four procedures were conducted without any complications. The procedures included navigating the MGW and passing it through the clot. Complete recanalization was achieved in all cases. The average time between femoral artery puncture and recanalization was 15 min. The use of the preshaped MPMGW in acute thrombectomy was effective in terms of both security of procedure and reduction in recanalization time.

show abstract

A Novel Technique of Safe and Versatile Microguidewire Shaping with Neuroendovascular Therapy: Modified Pigtail Method

Cited by 8 publications

References 1 publication

Carotid Cavernous Fistula during Thrombectomy for Acute Ischemic Stroke: A Case Report

Carotid Cavernous Fistula during Thrombectomy for Acute Ischemic Stroke: A Case Report

A novel technique for mitigation of the ledge effect caused by the use of a large-lumen catheter during neurointervention: Beanstalk method

Initial clinical experience of using a newly designed preshaped microguidewire in acute endovascular thrombectomy

Contact Info

Product

Resources

About