Abstract
A 60-year-old female patient presented with diplopia, facial pain, and recurrent episodes of headaches. A large symptomatic aneurysm of the left internal carotid artery (ICA) at the origin of a persistent primitive trigeminal artery (PPTA) was treated using a combined endovascular deconstructive technique with coils and a reconstructive technique with a flow diverter stent. DSA after 3 months showed a remnant of the aneurysm still present, and the patient was indeed still symptomatic. A second flow diverter stent was placed, which then led to a good clinical and angiographic result. This case illustrates the benefit of combining different endovascular techniques.Flow diversion is a treatment method used for large saccular sidewall aneurysms. However, if a flow diverter stent covers an aneurysm at the origin of an artery with high flow requirements, the aneurysm may take longer to completely occlude or even not occlude at all if only one flow diverter stent is implanted. Combining the techniques of coil occlusion and extrasaccular flow diversion is the main topic of this report, alongside an analysis of the association of this particular anatomic variant with more frequent presentations of cerebrovascular malformations.
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Lylyk, I., Viso, R., Muñoz, R., Chudyk, J., Lylyk, P. (2020). Internal Carotid Artery Aneurysm: Large Saccular Persistent Primitive Trigeminal Artery Aneurysm, with Mass Effect, Treated with Flow Diverter and Deconstructive Technique with Coils, Good Clinical Outcome, and Follow-Up Results. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Aneurysm Casebook. Springer, Cham. https://doi.org/10.1007/978-3-319-70267-4_145-1
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