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Double-Balloon Remodeling of Wide-Necked Aneurysms Distal to the Circle of Willis

Anil Arata and Barbaros Cila

a From the Department of Radiology, Hacettepe University Hospitals, Ankara, Turkey



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  		FIG 1. Case 1.

A, Left internal carotid arteriogram (working projection) before bypass of the aneurysm shows that both of the trunks of middle cerebral artery arise from the aneurysm. Microcatheter in the middle cerebral artery and in the anterior communicating artery aneurysm are noted.

B, Digital radiograph shows both catheters (HyperForm; Micro Therapeutics, Inc) in the superior and inferior trunks. Microcatheter tip is in the aneurysm.

C, Left internal carotid arteriogram after embolization of the anterior communicating artery aneurysm shows satisfactory obliteration of both aneurysms.



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  		FIG 2. Case 2.

A, Aneurysm viewed from its posterior aspect on a 3D angiogram, which shows involvement of the origins of both A2 segments. Small dashed arrow indicates left A1; large dashed arrow, left A2; small solid arrow, right A1; and large solid arrow, right A2.

B, Live road-map image shows the crossed pattern of catheters extending from A1 segments to the contralateral A2 segments and the catheter tip in the aneurysm.

C, Bilateral internal carotid arteriograms at the end of the procedure demonstrate a small neck remnant.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X