Endovascular Treatment of a Giant Intracranial Aneurysm with a Stent-Graft

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This report describes a giant intracavernous carotid aneurysm successfully treated by the placement of a single covered stent. A 40-year-old woman was admitted with a progressive diplopia in relation with palsy of the IV and VI cranial nerves. Magnetic resonance imaging revealed an intracavernous giant aneurysm located at the bifurcation between the origin of a trigeminal artery and the intracavernous portion of the right internal carotid artery. A covered stent was successfully placed, and complete exclusion of the aneurysm was confirmed at 11-month follow-up angiography. The use of covered stents in intracranial vascular structures can now be a feasible way of treating selected cases of wide-necked intracranial aneurysms.

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CASE REPORT

A 40-year-old woman was referred to our center with progressive diplopia of 3 months' duration resulting from palsy of the IV and VI cranial nerves. Magnetic resonance (MR) findings suggested a giant aneurysm at the level of the cavernous sinus. Neurologic examination confirmed complete dysfunction of the IV and VI cranial nerves, with no other neurologic alterations. Cranial MR and MR angiography revealed a nonthrombosed giant aneurysm at the level of the right cavernous sinus, producing

DISCUSSION

New devices developed in recent years have converted previously untreatable aneurysms into low-risk, treatable aneurysms. The balloon-assisted technique has proved to be a feasible, safe tool for managing broadnecked aneurysms (1), and the recent use of liquid agents associated with balloons or stents has also provided an effective means for treating these otherwise extremely difficult or untreatable aneurysms (2).

It is important not only to occlude a wide-necked aneurysm, but also to try to

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None of the authors have identified a conflict of interest.

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