PMC9899466_01
(a-p) Angiography images of the basilar tip aneurysm in case 1. Panels are described in detail in the text. The black arrow indicates the PulseRider deployed in the normal position. The yellow arrowhead indicates the device position after partial proximal withdrawal. The white arrows indicate the coil mass "jacked up" into the aneurysm.
SNI-14-9-g002.jpg
PMC9899466_01_SNI-14-9-g002.jpg
F2
On angiography, both PCAs were incorporated into the aneurysm wall and bifurcated laterally [Figures 2a and i]. A PulseRider (10T/3.5-4.5) was deployed in the extra-aneurysmal position, with the leaflets inside each PCA [Figures 2b and j]. An Axium Prime Frame 8 mm x 30 cm (Medtronic, Minneapolis, MN, USA) was inserted but deviated from the posterior space of the aneurysm [Figures 2c and k]. The PulseRider was temporarily withdrawn [Figures 2d and l] and the coil reinserted to create a spherical frame above it [Figures 2e, f, m, and n]. Then, the PulseRider was advanced to jack up the deviated coil [Figure 2g]. In the lateral view, the underside of the coil frame was pushed up [Figure 2o]. A total of 26 coils were added and successful embolization was achieved [Figures 2h and p].
PMC9899466_02
(a-j) Angiography images of the basilar tip aneurysm in case 2. Panels are described in detail in the text. The yellow arrowhead indicates the PulseRider in the withdrawn position. The yellow arrows indicate the coil mass "jacked up" into the aneurysm.
SNI-14-9-g003.jpg
PMC9899466_02_SNI-14-9-g003.jpg
F3
On angiography, both PCAs and SCAs branched off the wall in the middle of the dome [Figures 3a and f]. A PulseRider (10T/3.5-4.5) was deployed in the extra-aneurysmal position with the leaflets inside each PCA [Figures 3b and g]. Therefore, the PulseRider was temporarily withdrawn proximally and a coil frame was created above it [Figures 3c and h]. The PulseRider was then advanced to elevate the deviated coil frame [Figures 3d and i]. The second half of the coil was reinserted and 10 coils were added to achieve successful embolization [Figures 3e and j].
PMC9899466_03
(a-h) Angiography images of the basilar tip aneurysm in case 3. Panels are described in detail in the text. The yellow arrowhead indicates the PulseRider in the withdrawn position. The yellow arrows indicate the coil mass "jacked up" into the aneurysm.
SNI-14-9-g004.jpg
PMC9899466_03_SNI-14-9-g004.jpg
F4
Therefore, the PulseRider was temporarily withdrawn proximally [Figures 4a and e] and a coil frame created above it [Figures 4b and f]. The PulseRider was then advanced to jack up the coil frame [Figures 4c and g]. In the lateral view, the underside of the coil frame was recessed upward [Figure 4g]. A total of 28 coils were added and successful embolization was achieved [Figures 4d and h].