PMC5714937_01
(A) Angiography showed a blood blister-like aneurysm. (B) The distal end of the stent was detached from the delivery balloon. (C) Half-dilated balloon to anchor the stent (D) stent anchored to a half-dilated balloon. (E) Distal end of the stent was loose when the second Willis covered stent (WCS) was positioned. (F) Post-procedural angiography showed that aneurysm was disappeared.
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F1
The shape and location of the aneurysm indicated the diagnosis of a BBA at C6 segment (ophthalmic segment) of ICA (Figure 1A). Before dilation of the balloon, a control DSA was performed to confirm the position, yet we found that the distal end of the stent was already detached from the balloon (Figure 1B). We then withdrew the delivery wire to make the balloon and the stent corked into the Navien as a whole and eventually, the stent was safely pulled back into the 5 F Navien and retrieved successfully without leaving much damage to the vessel wall as shown by control DSA (Figures 1C,D). As shown in Figure 1E, though not detached, the distal end of the stent was loosened without evident shortening, the Navien was already pushed back to the cavernous segment. We then successfully released the Willis stent (Figure 1F) and the aneurysm was gone.
PMC5714937_02
(A) Computed tomography showed subarachnoid hemorrhage. (B) Angiography showed a blood blister-like aneurysm. (C) There is no stent between two markers. (D) Navien accessed to distal of aneurysm neck enough. (E) Willis covered stent (WCS) accessed to aneurysm neck smoothly. (F) The WCS was expanded successfully and covered the aneurysm neck.
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F2
Computed tomography showed subarachnoid hemorrhage (Figure 2A), so she was transferred to our department 3 days later for endovascular treatment. DSA showed a BBA located at C6 segment of ICA (Figure 2B). When the stent was sent out from Navien, there was no stent between two markers, and we were not sure where the stent was (Figure 2C). We retrieved the microwire and the whole system. So, for this case we chose to navigate Navien to distal of aneurysm neck enough (Figure 2D). Then, the WCS was expanded successfully and covered the aneurysm neck (Figures 2E,F).