PMC7332700_01
Representative Case 1. A 73-year-old woman was diagnosed with two unruptured aneurysms of the left basilar artery (BA) - superior cerebellar artery (SCA) bifurcation portion and the BA tip portion (a: Right vertebral artery angiography [Rt VAG]). Stent-assisted coil embolization was performed. A 4 mmx21 mm Neuroform Atlas stent was placed using the bulging technique, between the left PCA and BA trunk portion, covering the necks of both the left BA-SCA and BA tip aneurysms. After confirming the good stent bulging, effective covering of both aneurysmal necks and vessel wall apposition was seen on 3D-cone-beam computed tomography (3D-CBCT) (b: 3D-CBCT). Coiling both aneurysms was successfully performed according to the trans-cell method (c: Rt VAG, d: 3D-CBCT). Follow-up DSA at 6 months after the stent-assisted coil embolization showed complete occlusion of both aneurysms and good blood flow on stent placement (e: Rt VAG).
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F4
A 73-year-old woman was diagnosed with multiple unruptured aneurysms of the anterior communicating artery (A-com A), left basilar artery (BA), bifurcation of the superior cerebellar artery (SCA), and tip of the BA underwent coiling for BA aneurysms after clipping of the A-com A aneurysm [Figure 4a]. After confirming optimal stent bulging and effective covering of the aneurysmal necks and vessel wall apposition on 3D-CBCT with 8% diluted contrast media [Figure 4b], coiling of both aneurysms was successfully performed according to the trans-cell method [Figure 4c and d]. Follow- up angiography at 6 months after stent-assisted coiling showed complete occlusion of both aneurysms and a good blood flow of the parent artery and branches in the stent placement [Figure 4e].
PMC7332700_02
Representative Case 2. A 43-year-old male patient was diagnosed with an unruptured aneurysm of the left internal carotid artery-ophthalmic artery (Oph A) bifurcation portion (a: left carotid artery angiography (Lt CAG), b: Lt CAG translucent image). Stent-assisted coil embolization was performed. A 4.5 mmx21 mm Neuroform Atlas stent was deployed to protect the origin of the Oph A using the bulging technique. After confirming stent deployment with good herniation of the stent struts into the aneurysmal neck and the origin of Oph A and vessel wall apposition on 3D-CBCT (c: 3D-CBCT), coil embolization was performed as per the jailing technique (d: Lt CAG, e: 3D-digital subtraction angiography fusion image).
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F5
A 43-year-old male patient presented with a growing unruptured aneurysm of the left ICA at the bifurcation of the ophthalmic artery (Oph A) [Figure 5a and b]. Atlas stent was selected according to the diameter measuring 4.5 mm and deployed with the bulging stent to protect the origin of the Oph A. After confirming the stent deployment with optimal herniation of the stent struts into the aneurysmal neck and the origin of Oph A and vessel wall apposition on 3D-CBCT with 8% diluted contrast media [Figure 5c], coil embolization was performed using the jailing technique [Figure 5d and e].