CC-BY-NC-ND 4.0 · J Clin Interv Radiol ISVIR 2018; 02(01): 038-041
DOI: 10.1055/s-0038-1649325
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

Overcoming Tortuous Anatomy in Intracranial Intervention

Mathew Cherian
Department of Interventional Radiology, Kovai Medical Center and Hospital, Coimbatore, Tamilnadu, India
,
Pankaj Mehta
Department of Interventional Radiology, Kovai Medical Center and Hospital, Coimbatore, Tamilnadu, India
,
Poyyamoli Santhosh
Department of Interventional Radiology, Kovai Medical Center and Hospital, Coimbatore, Tamilnadu, India
,
Kareparambil R. Rahul
Department of Interventional Radiology, Kovai Medical Center and Hospital, Coimbatore, Tamilnadu, India
,
Gandhi Jenny
Department of Interventional Radiology, Kovai Medical Center and Hospital, Coimbatore, Tamilnadu, India
,
Swamiappan Elango
Department of Interventional Radiology, Kovai Medical Center and Hospital, Coimbatore, Tamilnadu, India
› Author Affiliations
Further Information

Publication History

Received: 20 November 2017

Accepted: 12 January 2018

Publication Date:
03 May 2018 (online)

Abstract

Intracranial interventions comprise a set of procedures, which are complex and challenging. Further, they are extremely risky because complications in the brain are usually associated with significant mortality and morbidity. Thus, a clear understanding is necessary to handle tortuous vessels because improper planning can result in a higher rate of complications. The combination of long sheaths, specialty wires, and preshaped catheters can enable us to access some of the most complex vascular anatomy. There are several conditions that can contribute to a difficult access. There are few techniques described by different authors. The authors have listed the techniques found useful based on their experience. These challenges include tortuous iliac arteries, dilated tortuous aortic arch, acute takeoff of the arch vessels, tortuous neck vessels with prominent loops, crossing a large aneurysm, extensive peripheral vascular disease, etc.