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Treatment of giant aneurysm with flow diversion

Case - 1
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A giant size irregular sac of aneurysm arising from cavernous segment of left internal carotid artery - view from front.
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Same aneurysm as seen from side.
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Balloon occlusion test was done by occluding left internal carotid  artery temporarily and injecting contrsat into left vertebral artery. There is no supply to left internal carotid territary.
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Similarly there is no supply to left internal carotid territary from right carotid artery as well. It means that left internal carotid artery can not be occluded as a treatment to this aneurysm.
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With great skill, guidewire has been passed across the aneurysm through very tortuous artery.
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First stent is ready to be deployed across aneurysm neck.
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Three arrows show two overlapping stents covering aneurysm sac.
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After deploying two stents for diverting flow, aneurysm is filling slowly  with stagnation of contrast.
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Stagnation of contrast in the aneurysm sac indicates that aneurysm will eventually thrombose( will get filled with blood clots)

 

We Acknowledge the help of Dr Uday Limaye, Mumbai  in performing this procedure

 

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