Microcatheter Shape Adjustment during Coil Embolization with the Leonis Mova Steerable Microcatheter.

Objective: The Leonis Mova (SB-Kawasumi Laboratories, Kanagawa, Japan) is a steerable microcatheter with a hand-operated dial that can be used to adjust the angle of the catheter tip. This steerable microcatheter has predominantly been used as an intermediate catheter. Herein, we report a case in which an aneurysmal subarachnoid hemorrhage was treated with coil embolization using the Leonis Mova microcatheter. Case Presentation: A 53-year-old woman was transferred to our hospital for the treatment of a sudden onset of headache and vomiting caused by a subarachnoid hemorrhage detected on CT. DSA showed a 7.5-mm left internal carotid artery-posterior communicating artery aneurysm with multiple blebs, which we treated with coil embolization under general anesthesia. After placement of a 7-Fr guiding sheath in the left internal carotid artery, we introduced the Leonis Mova Selective microcatheter and the Excelsior SL-10 microcatheter (Stryker, Kalamazoo, MI, USA) into the center of the aneurysm. We inserted 9 coils into the aneurysm via the double-catheter technique, during which we adjusted the angle of the Leonis Mova microcatheter to fill each bleb in a piecemeal fashion. Almost complete obliteration was achieved, and the patient was ambulatory and discharged after completing treatment for the vasospasm phase of a subarachnoid hemorrhage. Conclusion: The Leonis Mova may be a useful microcatheter for coil embolization of aneurysms with multiple blebs and a tortuous parent artery.