{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390282680276730624.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.5797/jnet.2.238"}},{"identifier":{"@type":"URI","@value":"https://www.jstage.jst.go.jp/article/jnet/2/3/2_238/_pdf"}},{"identifier":{"@type":"NAID","@value":"130002148688"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2009159151"}}],"dc:title":[{"@language":"en","@value":"Balloon-assisted Coil Embolization with Catheter Exchange Technique for Ruptured Wide-necked Large Basilar Tip Aneurysm : Case Report"},{"@language":"ja","@value":"Catheter Exchange Techniqueを用いたBalloon-assisted Coil Embolizationにて，治療し得た広頸大型破裂脳底動脈瘤の１例"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"<b>Objective</b>: Use of a catheter exchange technique for wide-necked large basilar tip aneurysms in which placement of a balloon catheter across the aneurysmal neck is difficult is described.<br><b>Case Report</b>: A 71-year-old woman presenting with severe headache and vomiting was diagnosed with a subarachnoid hemorrhage by CT on admission. Preoperative angiography indicated a large saccular aneurysm at the tip of the basilar artery, and coil embolization was performed. As the broad neck of the aneurysm was located between the basilar and left posterior cerebral arteries, a neck remodelling technique was necessary. However, placement of a balloon catheter was extremely complicated, and endovascular treatment failed, despite the use of different kinds of microguidewires and microcatheters on the first attempt. On the second attempt, a catheter exchange technique was used and the balloon catheter was able to be easily positioned. Successful embolization was achieved using the neck remodelling technique.<br><b>Technique</b>: First, a soft microcatheter was navigated through the basilar artery to the left posterior cerebral artery using a flexible microguidewire. Tips of the microguidewire and microcatheter were advanced to the distal part of the left posterior cerebral artery for stable positioning. The microguidewire was then exchanged for a long microguidewire, which was advanced into the microcatheter. The microcatheter was then removed over the wire. Next, a balloon catheter was advanced over the long microguidewire and positioned. Finary, coil embolization was achieved safely in the aneurysmal sac using the neck remodelling technique.<br><b>Conclusion</b>: A technique to bypass the aneurysmal neck to perform balloon-assisted endovascular treatment of large aneurysms with broad necks in which other methods fail to obtain access distal to the aneurysm was described. For cases in which placement of a balloon catheter is difficult, the catheter exchange technique is considered to be highly effective."},{"@language":"ja","@value":"<b>【目的】</b>バルーンカテーテルの誘導，留置困難な広頸大型脳底動脈瘤の症例に対するcatheter exchange techniqueの有用性を報告する．<b>【症例】</b>くも膜下出血にて発症した71歳の女性．出血源である広頸脳底動脈瘤へのコイル塞栓術を施行した．瘤頸部は脳底動脈から左後大脳動脈に渡って広く存在するため，治療においてneck remodeling techniqueが必須であった．しかし，バルーンカテーテルの誘導は困難であったため，初回の血管内治療はtrialで終わった．２回目の治療時には，catheter exchange techniqueの併用によりバルーンカテーテルは留置可能となり，適切な塞栓術を行うことができた．<b>【結論】</b>バルーンカテーテルの誘導，および留置困難な症例に対し，catheter exchange techniqueは有用な手技であると考えられた．"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410009221346281094","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000022003455"}],"foaf:name":[{"@language":"en","@value":"ITO Hidemichi"},{"@language":"ja","@value":"伊藤 英道"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, St.Marianna University School of Medicine"},{"@language":"ja","@value":"聖マリアンナ医科大学　脳神経外科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410009221346281093","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000022003459"}],"foaf:name":[{"@language":"en","@value":"MORISHIMA Hiroyuki"},{"@language":"ja","@value":"森嶋 啓之"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, St.Marianna University School of Medicine"},{"@language":"ja","@value":"聖マリアンナ医科大学　脳神経外科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410009221346281095","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000022003462"}],"foaf:name":[{"@language":"en","@value":"ONODERA Hidetaka"},{"@language":"ja","@value":"小野寺 英孝"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, St.Marianna University School of 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Yoshio"},{"@language":"ja","@value":"田口 芳雄"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"聖マリアンナ医科大学　横浜市西部病院　脳神経外科"},{"@language":"en","@value":"Department of Neurosurgery, St.Marianna University School of Medicine, Yokohama City Seibu Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410009221346281092","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000022003477"}],"foaf:name":[{"@language":"en","@value":"HASHIMOTO Takuo"},{"@language":"ja","@value":"橋本 卓雄"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, St.Marianna University School of Medicine"},{"@language":"ja","@value":"聖マリアンナ医科大学　脳神経外科"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"18824072"},{"@type":"LISSN","@value":"18824072"},{"@type":"EISSN","@value":"21862494"}],"prism:publicationName":[{"@language":"en","@value":"Journal of Neuroendovascular Therapy"},{"@language":"ja","@value":"脳神経血管内治療"},{"@language":"en","@value":"NOUSHINKEI KEKKANNAI TIRYOU"},{"@language":"en","@value":"JNET"}],"dc:publisher":[{"@language":"en","@value":"The Japanese Society for Neuroendovascular Therapy"},{"@language":"ja","@value":"一般社団法人 日本脳神経血管内治療学会"}],"prism:publicationDate":"2008","prism:volume":"2","prism:number":"3","prism:startingPage":"238","prism:endingPage":"244"},"reviewed":"false","url":[{"@id":"https://www.jstage.jst.go.jp/article/jnet/2/3/2_238/_pdf"},{"@id":"https://search.jamas.or.jp/link/ui/2009159151"}],"availableAt":"2008","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=basilar%20tip%20aneurysm","dc:title":"basilar tip aneurysm"},{"@id":"https://cir.nii.ac.jp/all?q=catheter%20exchange%20technique","dc:title":"catheter exchange technique"},{"@id":"https://cir.nii.ac.jp/all?q=coil%20embolization","dc:title":"coil embolization"},{"@id":"https://cir.nii.ac.jp/all?q=neck%20remodeling%20technique","dc:title":"neck remodeling technique"},{"@id":"https://cir.nii.ac.jp/all?q=wide-necked%20aneurysm","dc:title":"wide-necked 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