A 6F guide sheath for endovascular treatment of intracranial aneurysms

Stable insertion of guide catheters via the femoral route can prove difficult because of tortuous vasculature leading to failure of endovascular treatment of intracranial aneurysms. We report our experience using a long braided introducer sheath (6F Terumo Destination) with an inner diameter of 0.087 inches. It allowed the simultaneous use of multiple catheters or adjunctive techniques (balloon-assisted or stent-assisted coiling) while providing excellent support in 60 procedures involving coiling of anterior circulation aneurysms. The use of a long introducer sheath, by enhancing stability in the aortic arch and supraaortic vessels, provides another solution to the problem of vascular tortuosity that hinders endovascular treatment of intracranial lesions.