Echelon 10

Endovascular treatment was performed on the angiographic system (Artis zeego, Siemens AG, Healthineers, Forchheim, Germany). After general anesthesia, a long femoral sheath and a 6F guiding catheter (Johnson & Johnson, NJ, USA) were deployed, then the microcatheter was introduced at the target location. Treatment planning was carefully determined by three-dimensional (3D) rotational angiography.
Leo plus (Balt Extrusion, Montmorency, France) has its own microcatheter, and the Leo plus baby stent was delivered via a 0.017″ microcatheter or Echelon 10 (Medtronic, Irvine, CA, USA). Tirofiban hydrochloride (Yuanda Pharmaceutical Co. LTD, China) was used for acute thrombus within the stent, and if the stent was poorly opened, microcatheter massage of the stent or balloon dilatation was considered. Intracranial hemorrhage was routinely ruled out after the procedure by flat detector computed tomography (FD-CT).

The endovascular treatment was performed for patients under general anesthesia. A bolus of 50 IU/kg of heparin was given and routinely administered during the procedure to achieve an activated clotting time of >250 s. The femoral artery was introduced with a 6 Fr short sheath (Terumo, Japan), and a 6 Fr guiding catheter (Envoy; Johnson & Johnson, USA) was advanced to the proximal arterial lesion to establish a pathway. The structure of the lesion was assessed by 3D digital subtraction angiography using a standard biplane machine (Artis Zee Biplane; Siemens, Germany). Then, a microcatheter (Headway; Microvention, CA, USA) was placed in the parent artery to deliver the LVIS stent. The decision between selecting the LVIS or LVIS Jr. is contingent upon a multifactorial assessment, taking into account the diameter of the parent artery as well as the clinical experience of the surgeon involved. The structural characteristics of these two variations are summarized in Table 1. Another microcatheter (Echelon-10; Medtronic, USA) was carefully introduced into the aneurysm sac. The semi-jailing technique (21 (link)) was applied to assist in the coiling packing density. The stent was fully deployed following the completion of the embolization procedure.