J Korean Neurosurg Soc.  2014 Jan;55(1):32-35. 10.3340/jkns.2014.55.1.32.

Treatment for Giant Fusiform Aneurysm Located in the Cavernous Segment of the Internal Carotid Artery Using the Pipeline Embolization Device

• Oh SY
• Kim MJ
• Kim BS
• Shin YS

• KMID: 2191037
• DOI: http://doi.org/10.3340/jkns.2014.55.1.32

Abstract

The pipeline embolization device (PED) is a new endovascular device for treatment of complex, fusiform and wide-neck intracranial aneurysms. The main mechanism of this stent is to divert the flow in the parent artery with reduction of inflow in the aneurysm leading to thrombosis. We treated a 40-year-old woman who had left facial pain and orbit discomfort. Angiography showed a giant fusiform aneurysm located in the cavernous segment of the left internal carotid artery. A PED was successfully deployed across the aneurysm. The procedure and post-procedural course were uneventful. After 3 months, angiography showed complete obliteration of the aneurysm with good patency of the branching vessels originating from the deployed segment. The patient's symptoms improved completely without complications.

Keyword

Pipeline embolization device; Fusiform aneurysm

MeSH Terms

Adult
Aneurysm*
Angiography
Arteries
Carotid Artery, Internal*
Facial Pain
Female
Humans
Intracranial Aneurysm
Orbit
Parents
Stents
Thrombosis

Figure

• 

  Fig. 1 Preprocedural angiography with AP (A) and lateral (B) views and three-dimensional reconstruction angiography (C) show a giant fusiform aneurysm involving the cavernous segment of the left internal carotid artery.

• 

  Fig. 2 Immediate postprocedural angiography with AP (A) and lateral (B) views show that filling of the aneurysmal sac is slower than preprocedural angiography. DynaCT (C) shows stagnation of the contrast within the sac and good position with no redundant portions or stenosis of the device.

• 

  Fig. 3 AP (A) and lateral (B) views of 3-month angiography demonstrate anatomic reconstruction of the parent artery with complete occlusion of the aneurysm with the meningohypophyseal trunk preserved.

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