Article Figures & Data
Figures
- Fig 1.
A 50-year-old male patient presenting with HH grade I SAH. A, Transorbital view of the right ICA angiogram shows a small 1.3 × 1.7 mm BBA on the posteromedial ICA surface (arrow) on day 1 after ictus. B, Subsequent follow-up angiogram on day 4 shows no increase in size of the BBA (arrow). C, On day 10, marked expansion of the BBA, now measuring 2.6 × 2.9 mm, is noted (arrow). Stent-assisted coiling was subsequently performed on the same day. D, The final angiogram after placement of a single coil shows some residual filling of the BBA (arrow). E, Unsubtracted view of the final ICA angiogram after treatment demonstrates a single GDC coil inside the BBA (short white arrow) and end markers of the Neuroform stent within the supraclinoid ICA segment (long thin white arrows). F, Follow-up angiogram obtained 16 months after treatment reveals complete occlusion of the BBA.
- Fig 2.
A 49-year-old female patient who presented with severe SAH (Fisher/HH grades, 3/4). A and B, A very broad-based small BBA is found in the distal basilar artery trunk on initial DSA. C, At early angiographic follow-up on day 6, considerable growth of the BBA is noted (4.8 × 2.1 mm), prompting stent-assisted coiling. D, Angiogram immediately after treatment discloses residual proximal aneurysm filling. E, At 3 months' angiographic follow-up, progressive occlusion with a tiny dog ear remnant is evident. The patient made an excellent clinical recovery (mRS 1) at 5-month follow-up.
Tables
Patient Age/Sex Fisher Gradea HH Gradea Aneurysm Location/Side Aneurysm Level/Position Sizea (neck × depth) (mm) Neck-Dome Ratio Aneurysm Growthb Associated Findings 1 56/M 1 1 ICA/L C6-postmed 1.7 × 1.5 1.1 No Prox stenosis 2 54/F 3 1 ICA/L C7-lateral 2.4 × 1.9 1.3 Yes Prox stenosis 3 50/M 2 1 ICA/R C6-antmed 2.6 × 2.9 0.9 Yes 4 46/F 4 4 ICA/R C6-antmed 2.8 × 2.9 1.0 Yes 5 49/F 3 4 BA-T Anterior 4.8 × 2.1 2.3 Yes 6 44/F 3 2 ICA/R C6–7 antlat 6.8 × 2.1 3.2 No Fusiform dilation 7 44/M 4 3 ICA/R C6-antmed 1.6 × 1.5 1.1 Yes 8 35/M 1 1 ICA/L C6-antmed 2.5 × 1.5 1.7 Yes 9 50/M 3 4 ICA/R C6-med 8.0 × 12.0 0.7 No Partially thrombosed 10 70/M 4 2 ICA/L C6-postmed 5.0 × 2.0 2.5 Yes 11 51/F 1 1 ICA/L C6-antmed 3.3 × 3.7 0.9 No 12 44/F 2 1 ICA/R C6–7 post 7.0 × 8.0 0.7 No Partially thrombosed 13 44/F 2 3 BA-T Anterior 3.0 × 2.0 1.5 Yes -
a Fisher and HH grade and aneurysm sizes are provided at the time of treatment.
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b Aneurysm growth assessed between diagnosis and treatment.
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No. Clopidogrel/Aspirin (oral) Pre-EVT (mg) Clopidogrel (NGT)/Aspirin (IV) Pre-Stent+Coil (mg) Clopidogrel (NGT)/Aspirin (IV) Post-Stent±Coil (mg) Clopidogrel (oral) Postprocedure (mg)/Duration Aspirin (oral) Postprocedure (mg)/Duration Heparin Postprocedure/Duration 1 – 150/0 150/0 75/1.5 Months 150/6 Months IV/1 day + LMWH/1 week 2 0/300 – – – 150/1 Month IV/3 days 3 0/300 300/0 – 75/2 Months 100/Lifetime Low-dose s.c./14 days 4 300/300 – – 75/1 Day 100/1 Day IV/2 days 5 – 0/300 (NGT) 150/0 – 150/Lifetime IV/0.5 days 6 – – – – – IV/1.5 days 7 – 150/0 150/0 75/3 Days 75/12 Months – 8 0/320 – 150/0 75/1 Month 75/3 Months – 9 – 300b/500b – 75/1 Month 75/3 Months – 10 – 150/0 150/0 75/1 Month 75/3 Months – 11 – 300b/300b – 75/3 Months – IV/0.5 day + LMWH/6 days 12 – 0/500 0/150 75/1 Month 75/3 Months – 13 – 150/0 75/300 75/3 Months 150/6 Months – -
a All patients received intraprocedural IV heparin aiming at an ACT >2 × baseline.
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b Postcoil and prestent.
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