Neurointervention.  2016 Mar;11(1):46-49. 10.5469/neuroint.2016.11.1.46.

Progressive Deconstruction of a Distal Posterior Cerebral Artery Aneurysm Using Competitive Flow Diversion

• Johnson AK
• Tan LA
• Lopes DK
• Moftakhar

• KMID: 2155719
• DOI: http://doi.org/10.5469/neuroint.2016.11.1.46

Abstract

Progressive deconstruction is an endovascular technique for aneurysm treatment that utilizes flow diverting stents to promote progressive thrombosis by diverting blood flow away from the aneurysm's parent vessel. While the aneurysm thromboses, collateral blood vessels develop over time to avoid infarction that can often accompany acute parent vessel occlusion. We report a 37-year-old woman with a left distal posterior cerebral artery aneurysm that was successfully treated with this strategy. The concept and rationale of progressive deconstruction are discussed in detail.

Keyword

Stents; Intracranial aneurysm; Subarachnoid hemorrhage

MeSH Terms

Adult
Aneurysm
Blood Vessels
Endovascular Procedures
Female
Humans
Infarction
Intracranial Aneurysm*
Parents
Posterior Cerebral Artery*
Stents
Subarachnoid Hemorrhage
Thrombosis

Figure

• 

  Fig. 1 A. Three-dimensional rotational angiography of a left vertebral artery injection showing a very large left posterior cerebral artery (PCA) bifurcation aneurysm prior to treatment; (B) cerebral angiograms after initial coiling; (C) cerebral angiogram after second coiling; (D) six-month follow-up angiogram demonstrating significant recanalization of the aneurysm; (E) Virtual stenting (Siemens, Forchheim, Germany) of the planned flow diversion across the aneurysm neck and (F) the actual, eventual treatment using flow diversion across the aneurysm's parent vessel; (G) six-month post-operative angiogram after flow diversion demonstrating Raymond grade I occlusion of the left PCA aneurysm. PCA = posterior cerebral artery.

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