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Internal Carotid Artery Aneurysm: Giant Supraclinoid Aneurysm Treated with Telescoping p64 Flow Diverters with Complete Occlusion of the Aneurysm

  • Ivan Lylyk
  • Jorge Chudyk
  • Rene Viso
  • Carlos Bleise
  • Esteban Scrivano
  • Pedro LylykEmail author
Living reference work entry
  • 72 Downloads

Abstract

A symptomatic giant supraclinoid aneurysm was found in a 68-year-old female patient who had a history of mild hypertension. She presented with episodes of severe headache and visual disturbance of the right eye. The aneurysm was treated with a telescoping technique using two p64 flow-diverter stents (phenox). The patient was prepared for the stent implants with a course of dual-platelet function inhibition using acetylsalicylic acid (ASA) and clopidogrel 5 days prior to the procedure. The original plan for the procedure was to use a single flow-diverter device, but in the immediate DSA after the deployment of the first device, there was still a considerable amount of flow entering into the aneurysm sac. Therefore, a second device was placed, overlapping the first p64 at the aneurysm neck in order to further increase the flow diversion effect. The procedure was completed without any complications, and the patient was discharged after 3 days. The patient showed rapid clinical improvement. In the follow-up DSA performed 1 year after the procedure, the aneurysm was angiographically completely occluded, and the flow diverters as well as the parent vessel remained patent. On MRI no significant shrinkage of the meanwhile thrombosed aneurysm sac was encountered. The use of flow diverters to treat aneurysms located in the supraclinoid segment of the ICA is the main topic of this chapter.

Keywords

Supraclinoid ICA Flow diversion Complete angiographic occlusion Telescoping flow-diverter stents Space-occupying effect Giant aneurysm 

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Ivan Lylyk
    • 1
  • Jorge Chudyk
    • 1
  • Rene Viso
    • 1
  • Carlos Bleise
    • 1
  • Esteban Scrivano
    • 1
  • Pedro Lylyk
    • 1
    Email author
  1. 1.Clinica La Sagrada Familia, ENERIBuenos AiresArgentina

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