Balloon-assisted coiling through a single 6F guiding catheter.

The new version of the 6F Envoy guiding catheter, with its enlarged inner diameter of 0.070 inch, is capable of simultaneously accommodating both a 0.014-inch microcatheter and a balloon microcatheter for balloon-assisted coiling (BAC). We report our experience using this guiding catheter for access in BAC in 48 patients. The guiding catheter allowed for easy manipulations of 2 microcatheters, while providing sufficient quality of control angiograms during the procedure. In cases in which BAC is indicated, a larger guiding catheter (7F) or the commonly used bifemoral approach is no longer necessary, making the procedure technically simpler for the operator and less traumatic to the vessel wall.