Usefulness of modified pigtail-shaped microguidewire guidance for microcatheter navigation in difficult vasculatures during neuroendovascular interventions.

We previously reported using a microguidewire with a curved, pigtail-shaped tip as an anchor for navigating a microcatheter. However, we considered that the microcatheter could follow even if the tip of wire did not advance so far distally. The present study assessed the usefulness of a modified version of this pigtail-shaped microguidewire for navigating microcatheters to difficult vasculatures during neurointerventions. The microguidewire was repeatedly evaluated using a silicon tube vascular model. We also employed this method as the first choice for some patients. In both the in vitro tests and clinical use, the round curved tip could be used to position the microguidewire at the entry of a sharply angled vessel or aneurysmal neck, and the following catheter could then be advanced gently and easily. This technique allowed navigation of the microcatheter without inserting the guidewire into the distal vasculature.