Closed-Cell Stent for Coil Embolization of Intracranial Aneurysms: Clinical and Angiographic Results

A 59-year-old man referred for embolization of an incidentally discovered MCA aneurysm. 3D rotational angiography (A, frontal view) and DSA (B) show a wide-neck aneurysm involving both the smaller superior and the larger inferior M2 divisions (arrowheads) as well as the anterior temporal artery (double arrows). Note an aneurysm bleb projecting superiorly (arrow). Partial stent deployment (semi-jailing technique²⁰) with placement of a framing coil (C). Compartmental coiling with smaller fill coils and deployment of the stent (D). Final early and late arterial phase angiogram (E and F) shows obliteration of the aneurysm with delayed filling of the bleb (arrow, Raymond Class 3) and preservation of all involved MCA branches. Twenty-four-hour follow-up angiogram before discharge after discontinuation of the intraprocedural therapeutic heparin shows lack of delayed contrast filling of the bleb, most likely representing further thrombosis (G). Twelve-month follow-up angiogram (H) shows stable and complete aneurysm occlusion with preservation of all MCA branches.