TY - JOUR
T1 - Technical nuances of flow-diverting stent-assisted coiling of a ruptured carotid wall aneurysm
AU - Waqas, Muhammad
AU - Monteiro, Andre
AU - Almayman, Faisal
AU - Cappuzzo, Justin M.
AU - Metcalf-Doetsch, William
AU - Siddiqui, Adnan H.
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2024/2
Y1 - 2024/2
N2 - 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, https://drive.google.com/file/d/1EtyrJv3e5Z0XM2pYBNNBHVUdYwavlTFh/view?usp = 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.
AB - 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, https://drive.google.com/file/d/1EtyrJv3e5Z0XM2pYBNNBHVUdYwavlTFh/view?usp = 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.
KW - Pipeline embolization device
KW - aneurysm
KW - coiling
KW - ruptured
KW - subarachnoid hemorrhage
UR - http://www.scopus.com/inward/record.url?scp=85135455846&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85135455846&partnerID=8YFLogxK
U2 - 10.1177/15910199221117916
DO - 10.1177/15910199221117916
M3 - Article
C2 - 35929763
AN - SCOPUS:85135455846
SN - 1591-0199
VL - 30
SP - 128
EP - 129
JO - Interventional Neuroradiology
JF - Interventional Neuroradiology
IS - 1
ER -