Technical nuances of flow-diverting stent-assisted coiling of a ruptured carotid wall aneurysm

Muhammad Waqas, Andre Monteiro, Faisal Almayman, Justin M. Cappuzzo, William Metcalf-Doetsch, Adnan H. Siddiqui*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


The management of ruptured, large and giant wide-necked aneurysms of the anterior circulation is challenging. Treatment options include balloon-assisted coiling versus flow-diverter-assisted coiling. In this technical video, = sharing we demonstrate a case of a right-sided paraclinoid aneurysm in a young man who presented with post-coital sudden-onset headache. The computed tomography scan showed a Fisher grade IV subarachnoid hemorrhage. An external ventricular drain was placed, and the patient was intubated for prompt treatment. Balloon-assisted coiling of the aneurysm was attempted but abandoned because the balloon failed to provide adequate coverage of the aneurysm neck. A loading dose of aspirin and ticagrelor (Brilinta, Astra Zeneca, Cambridge, United Kingdom) was administered, and Pipeline embolization device (Medtronic, Dublin, Ireland)-assisted coiling was then performed for adequate occlusion of the aneurysm sac. The 6-month follow-up angiogram showed complete obliteration of the aneurysm. The technical video succinctly demonstrates the technical nuances of the procedure.

Original languageEnglish (US)
Pages (from-to)128-129
Number of pages2
JournalInterventional Neuroradiology
Issue number1
StatePublished - Feb 2024


  • Pipeline embolization device
  • aneurysm
  • coiling
  • ruptured
  • subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging


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