Stent-Assisted Coiling of Wide-Neck Intracranial Aneurysms Using Low-Profile LEO Baby Stents: Initial and Midterm Results

Preprocedural cranial CT and procedural and follow-up angiography images of a 44-year-old female patient with a ruptured PICA aneurysm. A, Cranial CT image obtained 9 days before the endovascular procedure (5 days following the rupture of aneurysm) shows the subarachnoid hemorrhage in the prepontine cistern. B, DSA image in a right anterior oblique projection reveals a 5-mm wide-neck aneurysm located on the medullary segment of the left PICA. C, DSA images obtained during the procedure show the catheterization of the parent artery for stent placement (black arrows) from the contralateral (right) vertebral artery and jailing of the coiling microcatheter (white arrows) through the ipsilateral (left) vertebral artery (the small filling defect in the aneurysm sac is a small air bubble introduced by the delivery of coil and trapped between the coil loops). D, DSA image obtained during the procedure shows the successful deployment of a LEO Baby stent (arrows) into the parent artery (PICA–vertebral artery). E, Immediate postprocedural DSA demonstrates the near-total occlusion of the aneurysm, with minimal filling in the neck. F, Six-month follow-up DSA shows complete occlusion of the aneurysm and a moderate degree of in-stent stenosis.

Pre- and postprocedural DSA and follow-up MR imaging and conventional angiography images of a 43-year-old female patient with a left MCA aneurysm. A, Preprocedural DSA image obtained at a left anterior oblique projection shows an 8-mm bilobed aneurysm located in the left MCA bifurcation. B, Intraprocedural roadmap DSA image shows the catheterization of the inferior trunk of the MCA (black arrows) and jailing of another microcatheter in the aneurysm sac (white arrows). C and D, Intraprocedural DSA images reveal complete occlusion of the superior lobule of the aneurysm after stent placement of the inferior MCA trunk (black arrows show the extension of the stent) and selective catheterization of the inferior lobule of the aneurysm for coiling. E, Immediate postprocedural DSA image demonstrates complete occlusion of the aneurysm. F, Three-month follow-up MR angiography image in a submentovertical projection demonstrates complete occlusion of the aneurysm and patency of the parent artery (arrows). G, Six-month follow-up conventional angiographic image shows complete stable occlusion of the aneurysm.

Procedural and follow-up angiographic images of a 42-year-old male patient with an AcomA aneurysm. A, Preprocedural DSA image obtained with bilateral internal carotid artery injections shows the wide-neck 8-mm AcomA aneurysm. B, DSA image obtained during the procedure demonstrates deployment of a LEO Baby stent extending from the left A2 to the right A1 (black arrows) and a jailed microcatheter in the aneurysm sac (white arrows). C, Postprocedural immediate DSA image shows complete occlusion of the aneurysm. D and E, Six-month follow-up DSA images demonstrate complete occlusion of the aneurysm and a mild degree of in-stent stenosis.