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AJNR - American Journal of Neuroradiology

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Direct Carotid Puncture for the Endovascular Treatment of Anterior Circulation Aneurysms

K. Nii^a, K. Kazekawa^a, M. Onizuka^a, H. Aikawa^a, M. Tsutsumi^a, M. Tomokiyo^a, M. Iko^a, T. Kodama^a, S. Matsubara^a, Y. Go^a and A. Tanaka^a

^a From the Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Japan

View larger version (103K): [in a new window]   Fig. 1. Photograph taken during the operation showing the direct insertion of a 5F sheath into the common carotid artery through the skin.

View larger version (28K): [in a new window]   Fig. 2. After the CCA was punctured percutaneously, a 5F sheath introducer of 5 cm was placed in the origin of the ICA. Tracker-38, as a guiding catheter, was inserted in the petrous or cavernous portion of the ICA. A microcatheter via Tracker-38 arrived in the aneurysm.

View larger version (113K): [in a new window]   Fig. 3. CT image of cervical region (top). Doppler sonogram (bottom) illustrates blood flow from the carotid artery to the subcutaneous hematoma.