Article Figures & Data
Figures
- Fig 1.
Cadaveric wide-necked basilar artery aneurysm replica of flow changes after parent vessel nondetachable balloon placement.
A, In the unaltered replica, fluid slipstreams enter the aneurysm sac through the distal neck (arrowhead) and impact upon the distal lateral aneurysm wall (arrow), the site of aneurysm rupture in the cadaveric specimen. Flow swirls within the aneurysm sac and exits the aneurysm neck peripheral to the distal central incoming jet, usually at the proximal portion of the neck.
B, Partial nondetachable balloon inflation, positioned in the parent vessel across the aneurysm neck, results in increased flow velocity of the intraaneurysmal fluid slipstreams, as well as greater impact against the aneurysm sidewall.
C, Complete nondetachable balloon inflation results in stasis of the intraaneurysmal fluid slipstreams. Distal parent vessel balloon positioning shows intraaneurysmal slipstream opacification.
- Fig 2.
Laboratory-created wide-necked aneurysm model after treatment with parent vessel nondetachable balloon placement and cyanoacrylate deposition.
A, Fluoroscopic image of nondetachable balloon inflated within the parent vessel lumen across the aneurysm neck. Concomitant microcatheter tip placement within the aneurysm sac allows simultaneous cyanoacrylate deposition.
B, After completion of aneurysm occlusion, microwire withdrawal allows balloon deflation. The microcatheter has also been removed, and the parent vessel lumen is opacified with iodinated contrast material. This control angiogram shows no flow within the aneurysm.
C, Resected aneurysm model shows concave molding of the cement cast surface at the parent vessel–aneurysm interface, creating a cylindric parent vessel surface profile.
- Fig 3.
Wide-necked basilar artery aneurysm replica after treatment with parent vessel stent placement and subsequent cyanoacrylate occlusion.
A, Fluid slipstreams lose coherence as they pass through the stent mesh, with little, if any, impact against the aneurysm sidewall. The flowing slipstreams generally remain within the center of the aneurysm sac, and the intraaneurysmal reverse vortex flow pattern previously demonstrated has changed to a more disturbed flow profile.
B, Fluoroscopic image of completed cyanoacrylate occlusion of the aneurysm sac. Parent vessel lumen opacified with iodinated contrast material shows no flow within the aneurysm. (Note: this particular image shown for descriptive purposes was taken from a different experimental embolization with use of an AVE stent.)
C, Resected aneurysm replica shows no evidence of cement penetration through the stent mesh.
