PMC5767481_01
Axial T2-weighted magnetic resonance image showing a right carotid cavernous aneurysm.
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F1
Magnetic resonance imaging showed a right carotid cavernous aneurysm (Fig. 1).
Pre-treatment angiogram of the right ICA showing a 20-mm carotid cavernous aneurysm.
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F2
Digital subtraction angiography (DSA) images confirmed the aneurysm measuring 20 mm in diameter (Fig. 2).
Cone-beam computed tomography image showing three telescopically deployed PEDs within the aneurysm sac.
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F3
PEDs (4.5 mm/30 mm, 4.75 mm/30 mm, 5 mm/30 mm) were telescopically deployed (Fig. 3). Posttreatment DSA images showed significant contrast stasis within the aneurysm (Fig. 4).
Post-treatment angiogram of the right ICA showing significant stasis of contrast medium in the aneurysm sac.
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F4
PEDs (4.5 mm/30 mm, 4.75 mm/30 mm, 5 mm/30 mm) were telescopically deployed (Fig. 3). Posttreatment DSA images showed significant contrast stasis within the aneurysm (Fig. 4).
Angiogram of the right ICA showing a dCCF: (A) frontal view, (B) lateral view.
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F5
DSA images showed the development of a right dCCF that drained into the right superior ophthalmic vein, the pterygoid venous plexus, the inferior petrosal sinus, the superior petrosal sinus, and via the intercavernous sinus into the contralateral cavernous sinus (CS) (Figs. 5A and 5B).
A microcatheter was transvenously inserted into the aneurysm sac via the rupture point (arrow).
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F6
A microcatheter (Excelsior SL-10; Stryker Neurovascular, Fremont, CA, USA) was advanced into the CS and further inserted into the aneurysm sac via the rupture point with the assistance of the microguidewire (Fig. 6).
Post-treatment lateral native image showing coil mass within the aneurysm sac and a small amount of coil mass within the CS adjacent to the rupture point (arrow).
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F7
After the aneurysm sac was embolized with some coils, the microcatheter was pulled back into the CS, and a few coils were put into the part of the CS adjacent to the rupture point for complete occlusion (Fig. 7).
Post-treatment angiograms of the right ICA showing complete disappearance of the dCCF: (A) frontal view, (B) lateral view.
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F8
Posttreatment DSA images showed complete resolution of the dCCF with aneurysm sac occlusion (Figs. 8A and 8B).