Baseline

A 77-year old woman was referred for treatment of two aneurysms (24x20mm and 20x18 mm),  arising from the inferior pancreaticoduodenal artery.

The celiac artery showed chronic total occlusion.

The case was discussed with the vascular surgery team and it was  decided to proceed for coiling embolization of both the aneurysms.

Procedure

A femoral approach was performed and pre-shaped microcatheters were chosen to reach the target lesions.

Many unsuccessful attempts to cannulate aneurysms were performed using  before a pre-shaped 45° tip and  than a 90° tip microcatheters.

After several failures, a Direxion™ 0.021" (0.53mm) Transend-14 System with pre-shaped Swan Neck tip was chosen.

Treatment

The torqueable Direxion was then successfully advanced over a Transend-14 guidewire  until it reached the two aneurysms.

The microcatether Swan-Neck shaped tip was crucial  to the success of the procedure because it facilitated access through  this challenging anatomy.

Coil-packing technique was then performed using detachable coils to achieve a complete embolization of  both aneurysms.

Result