MCA lobar shape wide neck aneurysm, involving M1, M2 and M3, case follow up!!
This 47 year old man has been treated with stent assist GDC embolization, the plan was to use one stent to protect M2 and M3, but end-up, two stent in coaxis manner applied. The patient has been discharged from ICU with GCS=15. The reason to use two metallic stent in co-axis manner was one of the loop of the coil prolapsed to the parent artery (M1) during the procedure. Complete embolization of the lobar aneurysm acquired eventually. Here is the case.
Comment
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Comment by Kuok Cheong U on July 24, 2010 at 9:41am -
Yes, your are right, although I have planned to use only one stent (Boston Scientific Neuroform3, 3mmx2cm) for complete embolization of the lobar shape aneurysm, however, I have over estimated the size of the aneurysm or because the aneurysm is lobar shape, one of the coil prolapsed or more precisely the "tail" of the coil jump out from the basket after detachment. So I need to use second 3mmx2cm stent to secure the prolapsed tail and find another way to finish the dense impaction.
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Comment by Tamrakar Karuna on July 24, 2010 at 8:54am -
Is it like....... one stent you applied before coil deployment and the second stent application was at the end or right after you'd noticed coil prolapse in M1 segment? Can you write about the stents you used in this case?
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Comment by Kuok Cheong U on July 7, 2010 at 5:19am
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Dear Karam,
Both M1, M2 and M3 segments are patently noted without lumen compromise, the patient is now on plavix 75mg/day and aspirin 100mg/day and I'll followup the patient 3 months later. So far, his is doing fine.
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Comment by Karam Chand Sharma on July 6, 2010 at 7:42am -
Dear Kuok,
Very good job. Is there any compromise of lumen of one of MCA branches? Most of MCA aneurysms arising from MCA can be clipped but case as this needs an expert like you. Show us pictures routinely.Congratulations.!
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