A195 Micro-guidewire electrocoagulation for the treatment of intracranial aneurysms that are inaccessible by microcatheterization

<h3>Introduction</h3> For those aneurysms that are inaccessible by a microcatheter due to a narrow neck or a thin and tortuous parent artery, endovascular embolization is apparently impossible and risky. <h3>Aim of study</h3> We presented our experience of using micro-guidewire electrocoagulation for the treatment of aneurysms that were inaccessible by a microcatheter. <h3>Method</h3> Eleven consecutive patients who underwent endovascular electrocoagulation for the treatment of aneurysms between January 2020 and May 2022 were retrospectively included. All of them were admitted with a subarachnoid hemorrhage (SAH) and a ruptured aneurysm confirmed by DSA. Endovascular electrocoagulation was performed using a Traxcess-14 micro-guidewire super-selected into the orifice of the aneurysm or the beginning segment of the parent artery. Electrocoagulation was performed at 4.0 V and 1.0 mA current for 30–60 seconds each time. Patient demographics, treatment procedures, and follow-up outcomes were assessed. <h3>Results</h3> All of the eleven aneurysms in 11 patients were successfully treated using micro-guidewire electrocoagulation. After electrocoagulation for 1–4 min, all 11 aneurysms disappeared on angiography. Parent artery occlusion was observed in eight cases, and post-procedure infarctions of the operating region were identified in three patients. 10/11 received MRS 0 at 3-month follow-up. 9 patients had complete obliteration of aneurysm at a mean follow-up time of 13.6 months, no rebleeding was found. <h3>Conclusion</h3> Endovascular electrocoagulation is practicable and effective in treating aneurysms that are in accessable with microcatheters. Studies on larger populations are needed to further confirm its safety and long-term outcomes. <h3>Conflict of Interest</h3> No