====== Distal Anchoring ====== **Distal anchoring** is a neurointerventional technique in which a device (such as a **balloon**, **coil**, or **guidewire**) is **intentionally placed in a distal (farther) segment of the vessel** beyond the target lesion (e.g., aneurysm) to provide **mechanical stability** and allow precise navigation, deployment, or treatment upstream (proximally). --- ### ๐Ÿง  Key Concept: > **"Fix the back end to control the front."** > By anchoring distally, you **immobilize the system downstream**, so that the **microcatheter or stent can be deployed more accurately upstream** without recoiling, looping, or herniating into the aneurysm. --- ### ๐Ÿ”ง Common Methods of Distal Anchoring: 1. **Balloon anchoring** A compliant balloon is inflated distally in a branch vessel (e.g., M2 segment) to **stabilize the microcatheter** while navigating across a wide-necked aneurysm. 2. **Coil anchoring** A framing coil is deployed (but not detached) in a distal vessel to **temporarily lock** the microcatheter in place. 3. **Wire anchoring** A microguidewire is deeply wedged into a distal vessel, providing tension and **support against backsliding**. --- ### ๐Ÿงช Example Use Case: > In treating a large wide-necked basilar tip aneurysm, the interventionist used **distal balloon anchoring** in the posterior cerebral artery to navigate a stent across the aneurysm neck via the **around-the-world technique**. --- ### โœ… Advantages: * Enables treatment in **complex, tortuous anatomy** * Improves **catheter stability** across wide-necked aneurysms * Reduces risk of **catheter prolapse** or **device misdeployment**