Published ahead of print on April 24, 2008
doi: 10.3174/ajnr.A1096
The Feasibility and Efficacy of Treatment with a Willis Covered Stent in Recurrent Intracranial Aneurysms after Coiling
M.-H. Li,
Y.-Q. Zhu,
C. Fang,
W. Wang,
P.-L. Zhang,
Y.-S. Cheng,
H.-Q. Tan and
J.-B. Wang
From the Department of Diagnostic and Interventional Radiology, Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, China
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Fig 2. Case 8, a 33-year-old woman with acute subarachnoid hemorrhage. A, Cerebral angiogram revealed a wide-necked aneurysm (arrow) at the origin of the posterior communicating artery (PcomA) and an infundibulum at the origin of AchoA (arrowhead) on the left ICA, respectively. B, The angiogram immediately after balloon-assisted coil embolization showed a subtotal occlusion of aneurysm. C, Recurrence of aneurysm was demonstrated on follow-up angiogram 3 months after coiling (arrow). D–F, Plain film showed the covered stent in place before balloon inflation (arrows), during balloon inflation (arrows), and deployment without balloon inflation (arrows), respectively. G, (slight oblique projection) and F, (lateral projection), Complete disappearance of aneurysm and excellent patency of AchoA (arrows) was shown by immediate angiogram after covered stent placement.
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Fig 3. Case 2, a 48-year-old man with a pseudoaneurysm, secondary to postballoon embolization of a carotid cavernous fistula. A, Lateral cerebral angiogram reveals a large pseudoaneurysm (arrow) on the right C3 segment of the ICA at 3 months of angiographic follow-up after balloon embolization. B, The immediate angiogram after coil embolization revealed near total occlusion of the aneurysm. C, The recurrence of aneurysm (arrow) was demonstrated on the 3-month follow-up angiogram after coiling. D, The recurrent aneurysm cavity was totally occluded after the placement of a 4- x 10-mm Willis covered stent. E and F, 3- and 12-month follow-up angiograms showed complete disappearance of aneurysm and excellent patency of the parent artery.
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Fig 4. Case 6, a 51-year-old man with acute subarachnoid hemorrhage. A, Anteroposterior cerebral angiogram revealed a dissecting aneurysm (arrow) on the right V4 of the VA. B, Plain film showed balloon-in-stent technique for the coil embolization of aneurysm. C, Immediate cerebral angiogram after coiling revealed subtotal occlusion of the aneurysm (arrow). D, 3-month follow-up angiogram after coiling demonstrated enlargement of the residual aneurysm cavity (arrow). E, Plain film showed deployment of the covered stent after balloon inflation (arrows). F, Total occlusion of the aneurysm sac and excellent patency of the parent artery was shown by immediate angiogram after covered stent placement. G, 3-month follow-up angiogram revealed the disappearance of aneurysm, with mild dilation of parent artery (arrows); this patient was still under close follow-up.
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