• Christopher R Durst, Robert M Starke, John R Gaughen, Scott Geraghty, K Derek Kreitel, Ricky Medel, Nicholas Demartini, Kenneth C Liu, Mary E Jensen, and Avery J Evans.
• Departments of Radiology and Medical Imaging and.
• J. Neurosurg.. 2014 Nov 1;121(5):1093-101.

ObjectThe endovascular treatment of wide-necked aneurysms can be technically challenging due to distal coil migration or impingement of the parent vessel. In this paper, the authors illustrate an alternative method for the treatment of wide-necked intracranial aneurysms using a dual microcatheter technique.MethodsThe authors' first 100 consecutive patients who underwent coil embolization of a wide-necked aneurysm using a dual microcatheter technique are reported. With this technique, 2 microcatheters are used to introduce coils into the aneurysm. The coils are deployed either sequentially or concurrently to form a stable construct and prevent coil herniation or migration. Angiographic and clinical outcomes are reported.ResultsThe technical success rate of the dual microcatheter technique is 91% with a morbidity and mortality of 1% and 2%, respectively. Clinical outcomes are excellent with 93% of patients demonstrating a modified Rankin Scale score of 0-2 at long-term follow-up regardless of their score at presentation. Retreatment rates are 18%.ConclusionsThe dual microcatheter technique may be a safe and efficacious first line of treatment for widenecked aneurysms.

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