ArticleNeuroradiology2013
The sheeping technique or how to avoid exchange maneuvers.
Article in Neuroradiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed.
- Initial Multicenter Evaluation of a Novel Anchoring Exchange Device: AI-based Quantitative Distal Tip-Motion Analysis.Clinical neuroradiology · 2026Article
- Mastering the Maze: A Narrative Guide on Advanced Tips and Tricks for the Management of Complex Thrombectomy.Stroke (Hoboken, N.J.) · 2026Review
- Transradial access with Simmons guiding catheter for carotid artery stenting: Feasibility and procedural complications in a single-center experience.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Distal anchoring techniques for reducing intra-aneurysmal (around-the-world) microcatheter loop prior to stent deployment across large wide-necked aneurysms- an educational review.Neuroradiology · 2025Review
- Efficacy of Pressure Cooker Technique in Redo Embolization for High-Flow Torcular Dural Sinus Malformation.Neurointervention · 2025Article
- Transvenous Embolization for Brain Arteriovenous Malformations.Journal of neuroendovascular therapy · 2025Review
- Transvenous embolization of the direct carotid-cavernous fistula via the pterygoid plexus: illustrative case.Journal of neurosurgery. Case lessons · 2023Article
- Pressure cooker technique in cerebral AVMs and DAVFs: different treatment strategies.La Radiologia medica · 2023Article
- Article
- Delayed Rupture of an Anterior Communicating Artery Pseudoaneurysm Caused by Distal Occlusion Thrombectomy Using a Stent Retriever: A Case Report and Mechanism of Injury.Neurointervention · 2022Article
- Kissing Aneurysms of the Posterior Inferior Cerebellar Artery Treated by Anchor Coil Technique and Stenting from the Contralateral Side: A Case Report.NMC case report journal · 2022Article
- Balloon-Assistance for the Transcirculation Access of a Remodeling Balloon for Coiling of Wide-Necked Aneurysms: Report of Two Cases.Neurointervention · 2021Article
- Carotid Artery Stenting Using the Snake Hunt Technique for Highly Tortuous Carotid Artery Stenosis: A Technical Note.NMC case report journal · 2021Article
- S-shaped distal access catheter supported microcatheter navigation into the lenticulostriate artery feeders of brain arteriovenous malformations.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2020Article
- Flow diversion in challenging vascular anatomies: the use of low profile stent retrievers for safe and accurate positioning of the microcatheter.CVIR endovascular · 2020Article
- Flow diversion beyond the circle of Willis: endovascular aneurysm treatment in peripheral cerebral arteries employing a novel low-profile flow diverting stent.Journal of neurointerventional surgery · 2019Article
- Vacuum for straightening the microcatheter after intra-aneurysmal looping: The "Lagman vacuum" technique.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2019Article
- The "temporary caging" technique for catheter navigation in patients with intracranial wide-necked aneurysms.International journal of clinical and experimental medicine · 2015Article
- A Novel Technique for Mitigation of the Ledge Effect Caused by the Use of a Large-Lumen Catheter during Neurointervention: Beanstalk Method.Asian journal of neurosurgeryArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe arteries of bifurcation aneurysms are sometimes so angulated or tortuous that an exchange maneuver is necessary to catheterize them with a balloon or stent delivery catheter. Because of the risk of distal wire perforation associated with exchange maneuvers, we sought to find an alternative technique.
methodsOur experience shows that a microcatheter tends to preferentially follow a previously placed microcatheter, even if the initial catheterization might be challenging. Accessing an artery with two microcatheters simultaneously may thus be an alternative to an exchange maneuver. Because of this tendency for catheters to behave like sheep following one another, we named this method the sheeping technique (ST). The ST consists of (a) first placing a 1.7 French microcatheter into the division branch requiring balloon or stent protection to straighten the course of the arteries in order to facilitate and (b) positioning in the same artery of a larger and stiffer balloon or stent microcatheter. Once the second balloon or stent microcatheter is in place, the first microcatheter can be pulled back and used to coil the aneurysm.
resultsBetween January 2009 and December 2012, The ST was successfully used in 208/246 procedures (85%). Conversion to an exchange maneuver was necessary in 38/246 (15%). There were no arterial perforations or ischemic events related to the handling of both microcatheters.
conclusionThe sheeping technique may improve safety by replacing the need for an exchange maneuver during difficult balloon- or stent-assisted coiling.
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