Utility of the Leonis Mova steerable microcatheter for coil embolization of a wide-neck aneurysm

Background: Leonis Mova is a steerable microcatheter that enables adjustment of the tip angle through a proximal manual dial. Although predominantly utilized as a distal access catheter in specific clinical scenarios, we present a case in which Leonis Mova was employed as the microcatheter for coil embolization of a ruptured wide-neck aneurysm in combination with an adjunctive technique. Case Description: An 88-year-old woman presented with sudden-onset headache and vomiting and was diagnosed with subarachnoid hemorrhage. Head computed tomography angiography revealed a left posterior inferior cerebellar artery aneurysm with a wide neck. Coil embolization was planned using the microcatheter protective technique. Under general anesthesia, a 4-Fr guiding sheath was inserted into the right vertebral artery (VA), and a microcatheter was delivered distal to the aneurysm’s parent artery through the contralateral VA approach to prevent coil herniation from the aneurysm neck. Subsequently, a 6-Fr guiding sheath was inserted into the left VA and a Leonis Mova Selective microcatheter was guided into the aneurysm sac. Four coils were deployed inside the aneurysm by adjusting the tip angle of Leonis Mova. Adequate aneurysm obliteration was successfully achieved without any perioperative complications. Conclusion: Leonis Mova may serve as a highly maneuverable and effective microcatheter for coil embolization of wide-neck aneurysms requiring complex adjunctive techniques.