Internal Carotid Artery Aneurysm Treated by Endovascular Flow Diverter

in Max Super Speciality Hospital, Saket

Feb 02 , 2023

A 67-year-old lady had complaints of progressive visual deterioration. On evaluation, she was found to have a giant left supraclinoid internal carotid artery (ICA) aneurysm with a left middle cerebral artery (MCA) bifurcation bleb. Surgical clipping was tried for the aneurysm before at another hospital but was abandoned. She was referred to Max Super Speciality Hospital, Saket, for further management.

She underwent Flow Diverter Placement with some coils in the aneurysm. Flow Diverter also covered the small bleb at MCA bifurcation. Challenge was the crossing of the giant aneurysm, as an entire segment of ICA was incorporated in the aneurysm, with entry and exit points at different places and extreme discrepancies in the size of proximal and distal vessel segments.

Aneurysm was crossed by taking the wire and microcatheter through the aneurysm. The microcatheter was straightened by using a stentriever, and a flow diverter was deployed with a few coils in the aneurysm.

Significant stasis was achieved in the aneurysm with a good distal flow. The procedure was uneventful, and the patient was discharged after three days without any deficits.