@article{JNI13091,
author = {Marina Hirato and Tomoaki Terada and Tomoyuki Tsumoto and Hiroo Yamaga and Hirotake Fujishima and Yu Sakamoto and Arisa Umesaki and Ikuya Natori and Ryouta Sakurai},
title = {N-butyl-2-cyanoacrylate (NBCA) embolisation for haemodynamic stress-induced peripheral aneurysm using a superfine microcatheter, DeFrictor Nano: surgical technique},
journal = {Journal of Neurointervention},
volume = {2},
number = {0},
year = {2026},
keywords = {},
abstract = {Haemodynamic stress-related peripheral aneurysms are well-recognized in patients with moyamoya disease and are known to occasionally re-rupture. However, endovascular treatment is challenging due to the small diameter of the parent artery. We describe two cases in which aneurysms potentially inaccessible by conventional treatment methods were embolised using a superfine microcatheter, and report on the surgical technique incorporating intraoperative videos and images. Two patients in their 50s presented with intracranial haemorrhage. One patient had already been diagnosed with moyamoya disease, while the other was attending their first consultation. Digital subtraction angiography was cross-referenced with computed tomography, which revealed that the sources of the haemorrhage were likely peripheral aneurysms in the posterior cerebral and anterior choroidal arteries. Endovascular embolisation was planned 3 and 13 days after the haemorrhage occurred to prevent re-rupture. The superfine microcatheter was successfully advanced proximally to the aneurysm, which was then embolised with N-butyl-2-cyanoacrylate. Post-operative angiography confirmed occlusion of the aneurysm. One case demonstrated microinfarcts on post-operative magnetic resonance image, but these were asymptomatic. Both patients were discharged within 1 week of surgery. Endovascular embolisation effectively prevented re-rupture of the peripheral aneurysm in two cases. Consistent with previous reports, access to distal vessels often poses a challenge in endovascular treatment. The superfine microcatheter facilitated navigation, which may result in higher procedural success for treatment of peripheral aneurysm.},
issn = {3104-8943}, url = {https://jni.amegroups.org/article/view/13091}
}