Abstract
BACKGROUND AND PURPOSE A complex middle cerebral artery (MCA) aneurysm failed surgical clipping. The aneurysm morphology was characterized by a broad neck with incorporated diminutive branch vasculature and mural calcification. To preserve flow within incorporated branch vessels, coil embolization with intraaneurysmal Neuroform stent implantation was achieved with a novel technique. METHODS AND RESULTS A 52-year-old female presented with an unruptured complex configuration right MCA bifurcation aneurysm. Endovascular coil embolization with intraaneurysmal stent deployment and compartmental dual microcatheter placement was performed a month after failed surgical clipping. Successful occlusion of the aneurysm with coil packing within and external to the stent was achieved with preservation of flow to the branch vessels. CONCLUSIONS Neuroform stent implantation within the aneurysm lumen and subsequent dual catheter coil embolization of the compartments external and internal to the stent is useful for successful occlusion of complex configuration cerebral aneurysms with incorporated branch vasculature.
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