PMC9610415_01
A 68-year-old male who presented with hematuria. Pre-operative contrast-enhanced axial CT angiogram showing a 2.0 cm aneurysm arising from the right main renal artery (white block arrow).
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F1
Before coil embolization, a planning Nexaris Angio-CT (Siemens, Erlangen, Germany) [Figure 1] was performed after obtaining right femoral arterial access and cannulating the right renal artery with a 5 French cobra catheter.
Computed tomography angiography 3D reconstruction in a 68-year-old male patient demonstrating the aneurysm arising from the distal right renal artery bifurcation (white block arrow).
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F2
Based on the 3D volumetric images [Figure 2], a decision was made to use the Comaneci device to protect the segmental arteries and facilitate coiling of the aneurysm.
Fluoroscopic spot image in the 68-year-old male patient showing the Comaneci devices used as scaffolding in two separate segmental vessels (black arrows) during coil deployment (white star).
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F3
TruSelect catheters (Boston scientific, Marlborough, MA) were used to individually select the two segmental arteries and the aneurysm sac. The Comaneci devices were advanced through the microcatheters in the segmental vessels and deployed as per the manufacturer's recommendation [Figure 3].
Digital subtraction angiogram of the right renal artery in a 68-year-old male patient showing successful coiling of the aneurysm (white star) with unchanged flow in the distal vessels (black arrows).
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F4
Following embolization, the Comaneci devices were withdrawn, and an additional angiogram was performed [Figure 4] to ensure adequate embolization and flow through the segmental vessels.
Follow-up contrast-enhanced computed tomography 1 month after the procedure in a 68-year-old male demonstrating successful embolization of the aneurysm (white arrow) with normal enhancement of the right kidney.
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F5
A follow-up CT angiography 1 month after the procedure demonstrated successful coiling without complication [Figure 5].