Kosin Med J.  2021 Dec;36(2):193-199. 10.7180/kmj.2021.36.2.193.

Flow Diverter Device for Treatment of Cerebral Aneurysm with Short-Term Follow Up: Two Case Reports

• Park JH

• KMID: 2524665
• DOI: http://doi.org/10.7180/kmj.2021.36.2.193

Abstract

The flow diverter device (FDD) is an important treatment method for cerebral aneurysms, especially for intracranial dissecting aneurysms. This paper is the result of FDD treatment for two cases of vertebral dissecting aneurysm (VADA) patients and short-term follow-up at 3 months. All two cases were targeted for unruptured cerebral aneurysm, and 4-vessel angiography was performed as a follow-up examination for 3 months after receiving the procedure. As result, it was possible to shorten the period of use of antiplatelet drugs. In the case of VADA, there are limitations in general coiling procedures or conventional surgical treatment methods. In that sense, the FDD treatment method can be a very effective alternative treatment of VADA

Keyword

Flow diverter device; Vertebral dissecting aneurysm

Figure

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  Fig. 1 In the brain MRI(A) and 4V angiography(B), a large dissecting aneurysm is observed in the right vertebral artery.

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  Fig. 2 After placing the microscatheter at the distal part of the right vertebral artery, FDD was loaded into the microscatheter. (A) Then, the microcatheter was removed and FDD was deployed in the lesion(black arrow)(B).

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  Fig. 3 Compared to Figure 1, it can be confirmed that the cerebral aneurysm was completely occluded in 3 months. (black circle)

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  Fig. 4 VADA is observed with vessel flap in Brain MRI(A), brainstem is being pressed due to mass effect and large VADA are identified in 4-vessel angiography. (B) It is observed that FDD was deployed, including VADA lesions. (C) The end point of the stent is indicated by a white arrow.) Image (D) is an immediately after the procedure. Stagnation of contrast agents is observed as an aneurysm sac.artery.

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  Fig. 5 It is a 4-vessel angiography examined after 3 months and compared to the previous image, a near total occlusion of aneurysm is observed. (A) And a decrease in the size of the aneurysm was observed on the taken brain CT (White arrow)(B).

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