{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T06:03:33Z","timestamp":1741068213476,"version":"3.38.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We report a case in which a novel distal access catheter proved successful in the placement of a flow diverter for a challenging distal cerebral artery lesion. We discuss the advantages and pitfalls of this technique and considerations for its use. A 74-year-old female presented with intermittent headaches, and was diagnosed with a dissecting aneurysm at the proximal right posterior cerebral artery with a sharp bleb, measuring 9.8\u2009mm in diameter. Given the complex vascular anatomy, stent-assisted coil embolization was initially considered but deemed high risk for dual catheter for jailing technique with 6-Fr size guiding catheter due to the tortuosity and stenosis of the parent vessel. Therefore, we opted for flow diverter treatment, which presented its challenges during delivery. By employing a low-profile distal access catheter, Phenom Plus (outer diameter: 4.2-Fr. inner diameter: 1.13\u2009mm; Medtronic, Minneapolis, Minnesota, United States), with a minimal ledge between it and the delivery catheter, Phenom 27 (outer diameter: 2.8-Fr, 0.91\u2009mm; Medtronic), we successfully crossed the neck of the aneurysm with Phenom Plus and placed the flow diverter. While acknowledging potential risks, this case demonstrates the value of the neck-crossing technique using a low-profile distal access catheter as an alternative option for treating challenging peripheral artery aneurysms with flow diverters. This technique offers promise in specific situations where conventional methods pose challenges.<\/jats:p>","DOI":"10.1055\/s-0044-1791711","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T23:19:18Z","timestamp":1729811958000},"page":"143-148","source":"Crossref","is-referenced-by-count":0,"title":["The Neck-Crossing Technique Using the Low-Profile Distal Access Catheter in Flow Diverter Placement for Dissecting Posterior Cerebral Artery Aneurysm: A Case Report"],"prefix":"10.1055","volume":"20","author":[{"given":"Akiko","family":"Hasebe","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8909-2949","authenticated-orcid":false,"given":"Ichiro","family":"Nakahara","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichiro","family":"Suyama","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoji","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Morioka","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadayoshi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeya","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junpei","family":"Koge","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Strokology, Fujita Health 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diversion","volume":"42","author":"A J Awad","year":"2017","journal-title":"Neurosurg Focus"},{"issue":"07","key":"ref10","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1136\/neurintsurg-2019-014770","article-title":"Periprocedural safety and technical outcomes of the new Silk Vista Baby flow diverter for the treatment of intracranial aneurysms: results from a multicenter experience","volume":"11","author":"M Mart\u00ednez-Gald\u00e1mez","year":"2019","journal-title":"J Neurointerv Surg"},{"issue":"10","key":"ref11","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1136\/neurintsurg-2016-012612","article-title":"Thrombogenicity of flow diverters in an ex vivo shunt model: effect of phosphorylcholine surface modification","volume":"9","author":"M W Hagen","year":"2017","journal-title":"J Neurointerv Surg"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"474","DOI":"10.3174\/ajnr.A7834","article-title":"The FRESH study: treatment of intracranial 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