Supraclinoid Internal Carotid Artery Aneurysm: Incidental Aneurysm, Flow Diverter Deployment Practicing in an 1:1 3D-printed Aneurysm Model, Complete Occlusion by Coil-Assisted p64 Flow Diversion
Aneurysms of the supraclinoid carotid segment are frequently occurring lesions. Growth and/or rupture may eventually lead to ophthalmoplegia and subarachnoid hemorrhage (SAH). Avoiding cranial nerve palsy and an SAH are the primary goals of treatment. In the past decade, new techniques involving endoluminal vessel reconstruction by flow diverters have become available and currently present an encouraging treatment alternative to surgery, coil embolization, or deconstructive parent vessel occlusion. Present data showing reliable aneurysm occlusion with low complication rates has led to a paradigm shift in managing these lesions. A female patient presenting with an incidental supraclinoid ICA aneurysm was treated with a p64 flow diverter. Prior to this treatment, the endovascular procedure was simulated using a 1:1 3D-printed endoluminal aneurysm model in order to investigate the optimal size and expected deployment behavior of the flow diverter to be used. Stereolithography was used to manufacture the vascular model to a high degree of precision from 3D rotational DSA image data. A flow diverter was then deployed in a 3D model, and the patient was treated accordingly. Post procedural angiography showed immediate hemostasis within the aneurysm and the follow-up DSA at six months showed complete occlusion of the supraclinoid aneurysm.
KeywordsICA Supraclinoid carotid aneurysm Flow diversion p64 Aneurysm model Stereolithography
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