Spontaneous subarachnoid hemorrhage is a disease with high mortality and disability rates. The most common cause is aneurysm rupture and bleeding. Aneurysms are preferentially treated with interventional embolization. Among the aneurysms that are treated with interventional embolization, some aneurysms have relatively wide necks, and it is difficult to achieve complete embolization using a single microcatheter embolization. Stents, balloons or other auxiliary embolization methods are required. Double microcatheter technology is an optional method with a specific scope of use.
Simple coil packing is more difficult for wide-necked aneurysms. Only with the help of balloons or stents can the embolization of wide-necked aneurysms be maintained while keeping the parent artery patency. However, its main disadvantages are:
1. There is an additional delivery system and the stent microcatheter is relatively hard, which is difficult to place for tortuous or distal aneurysms.
2. Antiplatelet aggregation drugs are required after surgery.
3. The balloon packing process requires temporary blockage of the parent artery blood flow, increasing the risk of ischemia.
4. The stent or balloon restricts the movement of the microcatheter and affects the packing effect.
5. The release of the stent at the bifurcation of the blood vessel may reduce the blood flow on the other side while protecting the blood flow on one side, thereby increasing the risk of ischemia.
Double microcatheter technology for embolizing aneurysms is mainly suitable for aneurysms with relatively wide necks, that is, aneurysms with a neck/tumor body greater than or equal to 0.5 but less than or equal to 1. The double microcatheter technology expands the scope of use of simple coil aneurysm packing. Compared with the defects of balloon or stent-assisted technology, its advantages are:
1. The operation is relatively simple. Two microcatheters can be operated at the same time through the same 6F guide catheter. The microcatheter is more flexible than the stent catheter and is easier to reach the distal blood vessels.
2. There is no need to temporarily block the tumor-bearing artery during surgery to reduce the risk of ischemia.
3. There is no need to worry about the need for antiplatelet aggregation after surgery due to stent placement.
4. Compared with single microcatheter embolization, the double microcatheter is in different positions in the aneurysm cavity, which greatly increases the dense embolization rate of the aneurysm and reduces the trouble of residual cavity or adjusting the position of the microcatheter during surgery.