Journal of JCIC

Online edition: ISSN 2432–2342
JCIC学会事務局 JCIC学会事務局
〒162-0801東京都新宿区山吹町358-5アカデミーセンター Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Journal of JPIC 2(2): 67-70 (2018)

症例報告Case Report

コイル塞栓術におけるステアリングマイクロカテーテルの有用性:機能的単心室1歳児例での使用経験Usefulness of steerable microcatheter in transcatheter coil embolization for aortopulmonary collateral arteries: A case report of 1-year-old patient with functional single ventricle

1あいち小児保健医療総合センター循環器科Department of Pediatric Cardiology, Aichi Children’s Health and Medical Center

2あいち小児保健医療総合センター新生児科Department of Neonatology, Aichi Children’s Health and Medical Center

受付日:2017年12月19日Received: December 19, 2017
受理日:2017年12月22日Accepted: December 22, 2017
発行日:2017年12月31日Published: December 31, 2017



A 1-year-old patient with complete atrioventricular septal defect, hypoplastic right ventricle, pulmonary stenosis, aortic overriding, and persistent fifth aortic arch underwent transcatheter coil embolization for aortopulmonary collateral arteries after bidirectional Glenn anastomosis. Access of a catheter from the femoral artery was required for an up-and-down course through the descending aorta, low-positioned persistent fifth aortic arch, solely originated right subclavian artery, and steeply curved right internal thoracic artery. A Judkins right catheter concomitant with a guidewire was unable to proceed to the right internal thoracic artery from the right subclavian artery. A conventional non-steerable microcatheter even combined with a tip-curled guidewire was also unachievable for the navigation to the target artery. Steerable microcatheter with a guidewire could easily navigate into the right internal thoracic artery. Subsequently the steerable microcatheter acted as a guide, and the Judkins right catheter was smoothly inserted to the artery. The patient safely underwent coil embolization by using the steerable microcatheter with the stably-positioned Judkins right catheter.

Steerable microcatheter will enable the navigation to target vessels which is previously thought to be difficult to navigate, and will contribute to reduction of the time and X-ray exposure required for an interventional procedure. Application of steerable microcatheter to a wide variety of usages is expected.

Key words: Steerable microcatheter; transcatheter coil embolization; aortopulmonary collateral artery; single ventricle; Glenn/Fontan physiology

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