Article Figures & Data
Figures
- Fig 1.
A 76-year-old woman (patient 2) presents with a lobulated 4.1-mm recurrence of a previously coiled 8-mm ICA aneurysm (arrow, A). After placement of a single PED, the recurrence remains visible (arrow, B). At the 6-month angiographic follow-up, recurrence of the aneurysm neck is smaller, but still visible (arrow, C). MRA performed 13 months after PED placement demonstrates complete occlusion of the aneurysm (arrows, D–E) and patency of the parent artery (arrowhead, E). Angiography at 30 months confirms the results of the MR angiography, demonstrating complete occlusion of the aneurysm and excellent reconstruction of the parent artery (F).
- Fig 2.
A 61-year-old woman (patient 9) presents with a 16 × 13 mm recurrence of a previously ruptured and subsequently coiled 22-mm ICA aneurysm at the origin of the posterior communicating artery (arrow, A). After placement of a single PED, flow reduction in the superior compartment of the aneurysm recurrence is demonstrated (arrow, B). Due to the broad base of the recurrence, a second PED is placed in a telescopic fashion to sufficiently cover the aneurysm neck and the adjacent arterial segments. After placement of the second PED, significant flow reduction is demonstrated (arrow, C). At the 6-month angiographic follow-up, complete occlusion of the aneurysm recurrence is visible (arrow, D). At the 30-month angiographic follow-up, the aneurysm recurrence is still completely occluded, with excellent reconstruction of the parent artery (arrows E and F).
- Fig 3.
A 51-year-old woman (patient 11) harboring an incidental 10-mm paraophthalmic aneurysm (arrow, A). Immediately after treatment with a single PED, only minimal residual flow is visible on angiography (arrow, B). Angiography also depicts a minimal pre-existing lumen narrowing shortly before the funnel-shaped origin of the posterior communicating artery (arrowhead, A–B). At 6-month follow-up, angiography and 3D reconstruction of the rotational angiography show complete occlusion of the aneurysm and 75% stenosis at the distal end of the PED (arrows, C and D). At that time, the PED is fully deployed (E), but a small translucent rim along the inner surface of the PED is visible (arrows, F–G). Percutaneous balloon angioplasty is performed 7 months after PED placement. Control angiography after 13 months demonstrates only minimal residual stenosis (about 30% lumen narrowing; arrow, H) that is completely resolved, as demonstrated on the 31-month angiographic follow-up (arrows, I). However, a small translucent rim, possibly resembling a neointimal layer, is still visible on angiography (arrows, I). There are no signs of recurrence of the aneurysm, which remains completely occluded.
Tables
Summary of patient characteristics and follow-up results
Patient Age/Sex Presentation Location Aneurysm Size (mm) Follow-Up (Angiographic; Mo) Follow-Up (CTA, MRA; Mo) Aneurysm Occlusiona (Mo) Clinical Outcome (GOS) 1 55/F SAH CAV 4.2 31 47 7 5 2 76/F Recurrence CAV 4.1 30 30 13 5 3 55/F Incidental OPHT 10 29 29 6 5 4 64/M Incidental CAV 5.2 27 27 7 5 5 68/F st.p.stent/coil non poss. OPHT 8 29 36 7 5 6 57/M st.p.stent/coil non poss. PcomA 6.1 30 30 6 5 7 55/M Mass effect OPHT 6.5 31 31 6 5 8 48/F Incidental PICA 7 30 30 5 5 9 61/F Recurrence PcomA 16 30 30 5 5 10 49/F SAH OPHT 7 7 29 5 5 11 51/F Incidental OPHT 10 31 43 6 5 12 37/F SAH OPHT 9 28 28 6 5 Note:—CAV indicates intracavernous segment of the internal carotid artery; mo = month; OPHT = paraophthalmic segment of the internal carotid artery.
↵a The given numbers refer to the time the complete occlusion of the aneurysm is first detected either by angiography or by CTA/MRA.
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