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).
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### 🧠 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.
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### 🔧 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**.
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### 🧪 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.
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### ✅ Advantages:
* Enables treatment in complex, tortuous anatomy * Improves catheter stability across wide-necked aneurysms * Reduces risk of catheter prolapse or device misdeployment