CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(04): 831-835
DOI: 10.1055/s-0043-1775586
Technical Note

Positional Relationship between Two Microcatheters according to the Navigation Sequence within the Curved Vessel in Neuroendovascular Procedures

Tomotaka Ohshima
1   Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Aichi, Japan
Shigeru Miyachi
1   Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Aichi, Japan
2   Department of Neurological Surgery, Aichi Medical University, Nagakute, Aichi, Japan
› Author Affiliations


In neuroendovascular treatment, there are many opportunities to guide multiple catheters into the intracranial blood vessels. We report the relationship between two microcatheters according to the guiding order with experimental in vitro studies. We hypothesize that in a bent blood vessel such as a paraclinoid region of the internal carotid artery, the catheter that was first guided tended to pass through the inside, and the catheter that was guided later tended to pass through the outside. The in vitro verification was performed using a microcatheter and a balloon catheter in a silicone vascular aneurysmal model. As a result, it was found that the two catheters were arranged according to our hypothesis. This finding was also observed during the actual operation of balloon-assisted coil embolization. The positional relationship between the two catheters according to the navigation order is very important, in particular during balloon-assisted coiling and stent-assisted coiling via a jailed microcatheter.

Authors' Contributions

Tomotaka Ohshima was involved in conceptualization, designing, literature search, and manuscript preparation. Shigeru Miyachi was involved in manuscript editing and review. All authors critically revised the article and provided final approval of the article.

Publication History

Article published online:
07 November 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Bouthillier A, van Loveren HR, Keller JT. Segments of the internal carotid artery: a new classification. Neurosurgery 1996; 38 (03) 425-432 , discussion 432–433
  • 2 Sheen JJ, Suh DC. Low-angled microcatheter approach for coil embolization of the anterior choroidal artery aneurysm. Neuroradiology 2017; 59 (10) 1053-1056
  • 3 Nelson PK, Levy DI. Balloon-assisted coil embolization of wide-necked aneurysms of the internal carotid artery: medium-term angiographic and clinical follow-up in 22 patients. AJNR Am J Neuroradiol 2001; 22 (01) 19-26
  • 4 Song Y, Kwon B, Al-Abdulwahhab AH, Kurniawan RG, Suh DC. Microcatheter stabilization technique using partially inflated balloon for coil embolization of paraclinoid aneurysms. Neurointervention 2021; 16 (02) 132-140
  • 5 Ohshima T, Kawaguchi R, Matsuo N, Miyachi S. Local balloon-assisted navigation of a microcatheter into an aneurysm during intracranial aneurysmal coiling: a dunk shot technique. Asian J Neurosurg 2021; 16 (02) 384-386