METHOD FOR EMBOLISATION OF CEREBRAL ANEURYSMS WITH A LIQUID ADHESIVE COMPOSITION Russian patent published in 2020 - IPC A61M25/01 A61L24/00 

FIELD: medicine.

SUBSTANCE: invention relates to endovascular neurosurgery. Left or right femoral artery is punctured. Then 0.035–0.038'' conductor is used to install diagnostic catheter in mouth of carotid and vertebral arteries. Angiography of carotid and vertebral arteries is performed. Aneurysm is detected and the an anatomy and position of the aneurysm is evaluated relative to the horizontal plane, the distal blood flow of the intracranial vessels is estimated. Thereafter, the diagnostic catheter is replaced with a balloon-occluding Corail+ guide wire catheter. Additionally, through the side channel of the system, heparinized 0.9 % NaCl solution with nimodipine is delivered drop-by-drop into the lumen of the vessel under control of arterial pressure within 90/60–100/70 mm of mercury. That is followed by a DMSO-compatible microcatheter with a detachable tip of 1.5 cm Sonic and inserted into a neck portion of the aneurysm. Performing the super selective angiography through the microcatheter lumen. Balloon is inflated at the end of the conductor catheter. Microcatheter is brought into the aneurysm cavity under the Roadmap navigation. Aneurysm bottom is filled with precipitated hydrophobic 25 % PHIL adhesive composition consisting of polylactide-co-glycolide copolymer and polyhydroxyethylmethacrylate dissolved in DMSO, with triiodophenol covalently bound with copolymer. Tear-off portion of the microcatheter is further inserted into the aneurysm cavity so that its proximal mark is at the level of the aneurismal neck, and the catheter tip has been directed to the bottom. Thereafter, the adhesive composition is introduced to the level of the neck, creating an effect "filled to the brim of the bowl", held for 2 minutes, then the tip is torn off, leaving the tear-off part in the cavity of the aneurysm. That is followed by blood aspiration through the lumen of the occluding conductor catheter, and the balloon is gradually blown off at the end of the guide catheter.

EFFECT: method enables preventing intra- and postoperative complications, reducing the risk of rupture of the aneurysm cavity by shortening the hardening time; prevent mass development effect, due to the less viscous consistency of the embolic agent, and filling the entire free space of the aneurysm cavity; reduced risk of thrombi migration from the aneurysm cavity, due to fast exposure of the adhesive composition, preventing artefacts in computer or magnetic resonance tomography in early or late postoperative periods due to use of iodine in the composition of an embolic agent instead of a contrast component.

1 cl, 1 ex