Coil Embolization of Very Small (2 mm or Smaller) Berry Aneurysms: Feasibility and Technical Issues

V. Gupta; M. Chugh; A.N. Jha; B.S. Walia; S. Vaishya

doi:10.3174/ajnr.A1374

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Fig 1.
A, ICA angiogram (lateral view). B, A 3D image profiling the aneurysm. C, DSA in the same angulation as the 3D image shows a very small aneurysm (arrow) and its relationship with the anterior choroidal artery (arrowhead). D, Postembolization DSA.
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Fig 2.
A, DSA image shows a doubtful left anterior communicating aneurysm. B, 3DRA image clearly shows the aneurysm involving the posteromedial wall in the A1 segment of the left ACA (arrow). C, DSA image profiling the aneurysm. D, Postembolization DSA. Inset shows the coil loop.
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Fig 3.
A, DSA image (anteroposterior view). B, 3D image shows a small aneurysm at the origin of the posterior choroidal artery. C, DSA in the same angulation as the 3D image. D, Coil embolization with balloon assistance. E, Postembolization DSA. F, Follow-up DSA (note the coil artifact in the inset image).
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Fig 4.
A, DSA image (anteroposterior view). B, 3D image showing the aneurysm (arrow). C, DSA in the same angulation as the 3D image. D, 3D image, with the white line indicating the conventional concept of the aneurysmal neck and the black line indicating the aneurysmal neck considered by us, to allow a coil bulge so as to reconstruct the bifurcation. E, Angiogram before coil detachment shows a well-placed coil with the microcatheter tip outside the aneurysm. F, Angiogram after coil detachment.