Coil embolization through the Marathon microcatheter: Advantages and pitfalls

Abstract

<jats:p> Due to technical limitations, small, distal, and tortuous intracranial pathology is sometimes out of reach of the current armamentarium of microcatheters designed for intracranial coil embolization. The Marathon microcatheter (Medtronic, Minneapolis, Minnesota, USA), designed specifically for the delivery of Onyx, is longer and more flexible than most coil delivery catheters. We report on nine patients (three with arteriovenous fistula, three with arteriovenous malformation, two with intracranial aneurysm, and one with tumor) where Marathon was used to deliver commercially available platinum coils. We also conducted laboratory compatibility testing and conclude that the Marathon can be used as a coil delivery catheter for Barricade coils (Blockade Medical, Irvine, California, USA) with diameter less than 0.012 in. </jats:p>

Super-selective coil embolization of a basilar perforator artery aneurysm previously treated by the stent-in-stent technique, using an extremely soft bare coil delivered through a one-marker microcatheter

“…The Marathon has already been used to deliver coils, including EDC-10 ES which are the only ones for which correct positioning of the detachment point is indicated by an audible alarm, thereby obviating the need for a proximal marker. 16 Though the trans-cell catheterization through the mesh of overlapping stent have been descripted, 17 to our knowledge, the clinical case reported here is the first description of aneurysm embolization using EDC-10 ES coils delivered via a Duo microcatheter through the mesh of two previously placed stents. Adding a flow diverter inside the two previous stents was not a contemplated solution.…”

Coil Embolization of Unruptured Distal Anterior Cerebral Artery Aneurysm Using a Marathon Microcatheter

“…Only nine cases have been reported in which Marathon was used for coil embolization of aneurysms (Table 1 ) [ 1 - 5 ]. Becket et al reported that Marathon was useful for distal posterior inferior cerebellar artery aneurysms because of its small diameter and long effective length [ 1 ].…”

“…Although there are restrictions on the coils that can be used, sufficient embolization of aneurysms is possible even with Marathon. To date, only nine cases have been reported in which Marathon was used for coil embolization of aneurysm, but no reports have been used in coil embolization of distal anterior cerebral artery (ACA) aneurysms [ 1 - 5 ]. We have reported a successful case using Marathon in coil embolization in case of a distal ACA aneurysm.…”

Embolization of a peripheral cerebral aneurysm associated with intracranial major artery occlusion through a transdural anastomotic artery: Case report

“…The OA is usually highly tortuous, and it is quite difficult to advance a microcatheter to the distal part of the artery. But the recent development of endovascular devices such as the triple-coaxial system 13 and flow-guide catheters, 14,15 as well as the advancement of endovascular treatment technique, has enabled the occlusion of deep-seated peripheral aneurysms. Because ED coil has the finest delivery wire system, it can be delivered through a Marathon catheter.…”