Selective Endovascular Treatment of Intracranial Aneurysms with a Liquid Embolic: A Single-Center Experience in 39 Patients with 41 Aneurysms
Boris Lubicza,
Michel Piotinb,
Charbel Mounayerb,
Laurent Spelleb and
Jacques Moretb
a Department of Radiology, Erasme University Hospital, Brussels, Belgium
b Department of Interventional Neuroradiology, Foundation Rothschild, Paris, France
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FIG 1. Incidental aneurysm discovered at MR angiography in a 39-year-old woman with headaches.
A and B, Left ICA conventional (A) and 3D (B) angiograms show a wide-neck bilobed carotid-ophthalmic aneurysm.
C, Road map obtained during balloon inflation and delivery of liquid embolic.
D, Follow-up angiogram obtained immediately after treatment shows complete occlusion of the aneurysm and patency of the ICA.
E, Follow-up angiogram obtained at 24 months shows stable occlusion of the aneurysm.
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FIG 2. Incidental aneurysm discovered at MR angiography in a 48-year-old man with headaches.
A, Left ICA angiogram shows a giant aneurysm of the anterior communicating artery.
B, Road map obtained during balloon inflation at the aneurysm neck and delivery of liquid embolic.
C, Follow-up angiogram shows liquid embolic fills the major part of the aneurysmal sac. Coils were then added to complete the aneurysm occlusion at the neck.
D and E, Follow-up nonsubstracted (D) and substracted (E) angiograms at the end of treatment show complete occlusion of the aneurysm.
F, Follow-up angiogram at 24 months shows stable occlusion of the aneurysm.
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FIG 3. Basilar artery aneurysm in a 48-year-old woman who presented with symptoms of progressive hemiparesis.
A, Left vertebral angiogram shows a giant basilar tip aneurysm.
B, Nonsubstracted angiogram obtained during inflation of two remodeling balloons and delivery of liquid embolic.
C, Follow-up angiogram obtained immediately after selective endovascular treatment with liquid embolic shows complete occlusion of the aneurysm.
D, Follow-up angiogram obtained at 12 months shows partial recanalization of the aneurysm.
E and F, Follow-up nonsubstracted (E) and substracted (F) angiograms obtained after a second embolization with coils only, show complete occlusion of the aneurysm.
G, Follow-up angiogram obtained at 12 months after second procedure shows persistent complete occlusion of the aneurysm.
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FIG 4. Incidental ICA aneurysm in a 36-year-old woman.
A, Right ICA angiogram shows a wide-necked supraclinoid aneurysm.
B and C, Follow-up nonsubstracted (B) and substracted (C) angiograms obtained immediately after selective endovascular treatment with liquid embolic show the cast of Onyx (arrow in B), a complete aneurysm occlusion and a nonsignificant ICA stenosis (arrow in C).
D, Follow-up angiogram obtained at 24 months shows stable occlusion of the aneurysm and a discrete ICA stenosis (arrow).
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