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AJNR - American Journal of Neuroradiology

Published ahead of print on October 10, 2007
doi: 10.3174/ajnr.A0767

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Evaluation of a Neck-Bridge Device to Assist Endovascular Treatment of Wide-Neck Aneurysms of the Anterior Circulation

K. De Keukeleire^a, P. Vanlangenhove^a and L. Defreyne^a

^a From the Department of Vascular and Interventional Radiology, Ghent University Hospital, Ghent, Belgium

View larger version (143K): [in this window] [in a new window]   Fig 1. A, Patient 8: right carotid DSA shows a carotid bifurcation aneurysm, partially recanalized due to coil compaction after coil-only embolization 6 months before. B, Plain digital image shows the compacted coils and, partially, the 3 nitinol petals of the TriSpan-10 device (arrows). C, Right carotid DSA shows thrombus (arrows) at the bifurcation in front of the neck. D, Right carotid DSA 1 day after treatment with intra-arterial urokinase and intravenous glycoprotein IIb/ IIIa receptor inhibitor demonstrates resolution of the thrombus and a "dog ear" at the medial site of the neck (arrow).

View larger version (88K): [in this window] [in a new window]   Fig 2. A, Patient 1: left carotid DSA shows a wide-neck MCA aneurysm with temporal and parietal branches (arrows) originating from the base. The TriSpan-12 is already in position. B, Plain digital image of a TriSpan configuration. The 3 nitinol "petals" are partially marked with platinum (arrowheads) and fixed by a coiled platinum "stem" wire (arrow). Markers of the coiling microcatheter (with the first coil inside) are indicated by asterisks. The proximal marker of the TriSpan-carrying microcatheter is indicated by a white arrow. C, Control left carotid DSA after embolization shows a "dog ear" (arrow) at the neck-parent vessel junction. D, Left carotid DSA at 8 months shows recurrence at the neck (asterisk) by coil compaction. E, Left carotid DSA after recoiling again shows a "dog ear" (arrow) at the neck-parent vessel junction.

View larger version (57K): [in this window] [in a new window]   Fig 3. A, Patient 14: left carotid DSA shows the asymmetric placement of the 3 TriSpan nitinol loops (arrows) at the neck of the aneurysm. B, Left carotid DSA shows complete occlusion of the aneurysm.