Undulating microcatheter tip motion with respiratory cycle during intracranial aneurysm embolization: description of a case and strategy for its mitigation.

Abstract

The present report describes a technique for mitigating respiration-related microcatheter motion during endovascular aneurysm treatment by modulating ventilator settings. A rare phenomenon of microcatheter tip movement related to respiration is demonstrated. An adjustment of tidal volume and respiratory rate reduced the degree of inspiratory vessel elongation and stabilized the microcatheter position, allowing for safer, more precise coil deployment. This maneuver can easily be applied to other endovascular procedures for which aberrant microcatheter motion must be minimized.