Article Figures & Data
Figures
- 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.
- 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.
- 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.
- 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).
Tables
Site of Aneurysm Number (%) of Aneurysms (n = 41) Supraclinoid ICA 29 (71) Cavernous ICA 7 (17) Basilar tip 2 (5) Anterior communicating artery 2 (5) ICA bifurcation 1 (2) - TABLE 2:
Endovascular techniques and occlusion in 37 patients with 39 intracranial aneurysms
Endovascular Technique Immediate Occlusion Angiographic Follow-up Complete Neck Remnant Further Thrombosis Unchanged Recanalization Group 1 Liquid embolic 9 0 0 7 2 Stent + liquid embolic 2 0 0 2 0 Group 2 Liquid embolic and coils 9 6 1 5 9 Stent + liquid embolic and coils 9 4 2 11 0 Total 29 10 3 25 11 Note.—Two patients each with one intracranial aneurysm died.
Patient Sex/Age (y) Aneurysm Location Complication Clinical Outcome Group 1 F/39 Cavernous ICA Migration of liquid embolic Excellent F/39 Supraclinoid ICA Migration of liquid embolic Visual field defect F/50 Supraclinoid ICA Nonsignificant ICA stenosis Excellent F/36 Supraclinoid ICA Nonsignificant ICA stenosis Excellent Group 2 F/43 Basilar tip Proximal vessel perforation Death F/66 Supraclinoid ICA Migration of liquid embolic Significant hemiparesis F/47 Supraclinoid ICA Distal vessel perforation Excellent F/53 Supraclinoid ICA Migration of liquid embolic Mild hemiparesis
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