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FIG. 2. Case 4.
A, Skull radiograph, anteroposterior view, shows coils in previously embolized left ICA aneurysm; B, right anterior oblique projection of right ICA angiogram shows bilobate lateral-wall ICA aneurysm (wide arrow) and unilobar medial-wall aneurysm (thin arrow); C, 3D reconstruction, same view, shows bilobate lateral-wall aneurysm (large straight white arrow) and medial-wall aneurysm (small straight white arrow) of right ICA (curved arrow) as well as coil mass from embolized left ICA aneurysm (wide arrow), gray arrows are orientation markers from the reconstruction; D, same projection, higher magnification, shows nonsubtracted view of balloon and embolization catheters during embolization of anterior lobe of the lateral-wall aneurysm; the balloon catheter and wire are coming up the ICA and extending into the MCA (white arrows); the embolization catheter, which has a coil in it, comes up the right VA, into the BA, then into the right P1, PCom, ICA, and aneurysm (black arrows); E, schematic view shows course of balloon and embolization catheters in this case; F, post-embolization right ICA angiogram shows complete packing of the lateral wall ICA aneurysm; G, post-treatment skull radiograph, anteroposterior view, shows coils in right ICA bilobate aneurysm.
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