Flow-diverting stent-assisted coil embolization of a ruptured internal carotid artery blister aneurysm with the pipeline flex embolization device

Dale Ding, Robert Starke, Ayton Hope, Stefan Brew

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Internal carotid artery (ICA) blister aneurysms are rare and challenging to successfully treat, using contemporary surgical or endovascular approaches, without partial or complete compromise of the parent vessel. We describe the use of a resheathable flow diverter, the Pipeline Flex Embolization Device (PFED) to perform stent-assisted coiling of a ruptured supraclinoid ICA blister aneurysm in a 56-year-old female who presented with a high-grade subarachnoid hemorrhage (SAH). The first PFED was deployed across the aneurysm neck to jail a microcatheter within the aneurysm dome, and then, two small coils were delivered into the aneurysm. After removing the coiling microcatheter, the second PFED was telescoped into the first PFED. There were no postprocedural complications, and follow-up magnetic resonance angiography 15 months after embolization showed complete aneurysm obliteration. Flow-diverting stent-assisted coiling should be considered as a reconstructive, vessel-preserving, endovascular treatment option for appropriately selected patients with ruptured ICA blister aneurysms. However, future studies are necessary to assess the periprocedural safety in the setting of acute SAH.

Original languageEnglish (US)
Pages (from-to)664-667
Number of pages4
JournalJournal of Neurosciences in Rural Practice
Volume8
Issue number4
DOIs
StatePublished - Oct 1 2017

Keywords

  • Blister intracranial aneurysm
  • endovascular procedures
  • flow diversion
  • Pipeline Flex
  • subarachnoid hemorrhage

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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