PMC10370513_01
(A) MRI showing a large dolichoectatic vertebrobasilar aneurysm. (B) MRI showing a giant mass effect around the brain stem. (C and D) Frontal and lateral views of right vertebral angiogram revealing the morphology of the aneurysm.
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F1
On MRI (Fig. 1A and 1B) and DSA (Fig. 1C and 1D), a large, thrombosed aneurysm (37 mm in length) was found from the right vertebral artery to the basilar artery.
(A) Cone beam CT confirming that the overlapping stents were placed from the tip of the right posterior artery to the right vertebral artery. (B and C) Six months after surgery, DSA showed favorable vascular remodeling with overlapping stenting. (D) Six months after surgery, MRI showed no enlargement in the thrombosed aneurysm.
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F2
Cone beam CT confirmed that the overlapping stents were placed in the targeted position (Fig. 2A). Six months after surgery, DSA confirmed favorable vascular remodeling with overlapping stenting (Fig. 2B and 2C), and MRI showed no enlargement in the thrombosed aneurysm (Fig. 2D).
(A) One year and seven months after surgery, MRI showed a change in signal intensity in the thrombosed aneurysm (arrow). (B-D) DSA showing that the vessel had become more tortuous, with findings of inadequately overlapping stents and leakage of contrast outside the stent (arrows).
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F3
At 1 year and 7 months after surgery, MRI T2-weighted image showed a change in the signal intensity in the thrombosed aneurysm (Fig. 3A). DSA showed that the vessel becomes more tortuous and found inadequately overlapped stents and leakage of contrast outside the stent (Fig. 3B-3D).
(A and B) One year after FRED placement, the contrast leakage outside the stent slightly increased on DSA. (C) One year after FRED placement, MRI showed no enlargement of the thrombosed aneurysm. FRED: flow redirection endoluminal device
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F4
One year after FRED placement, the contrast leakage outside the stent slightly increased on DSA (Fig. 4A and 4B), but there was no enlargement of the thrombosed aneurysm on MRI (Fig. 4C) or deterioration of the patient on the modified Rankin Scale score.