Challenging access during flow diversion treatment of a giant cavernous ICA aneurysm

Authors

Visish M. Srinivasan, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Joelle N. Hartke, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.Follow
Joshua S. Catapano, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.Follow
Ethan A. Winkler, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Ashutosh P. Jadhav, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.Follow
Felipe C. Albuquerque, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.Follow
Andrew F. Ducruet, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Document Type

Article

Abstract

A man in his 60s presented with severe ophthalmoparesis and loss of visual acuity in his right eye. He was found to have a giant aneurysm of the cavernous internal carotid artery (ICA). Treatment with a flow diverter was recommended. The aneurysm caused matricidal outflow restriction of the ICA. Microwire and microcatheter access through the aneurysm was challenging, requiring multiple wires, stentriever reduction, and more. Eventually, a construct of 3 Pipeline embolization devices was created across the aneurysm. Troubleshooting access across giant aneurysms is an important part of treatment. Informed consent was obtained for the procedure and for publication. The video can be found here: https://stream.cadmore.media/r10.3171/2022.7.FOCVID2258.

Keywords

Pipeline, aneurysm, microwire

Publication Date

10-1-2022

Publication Title

Neurosurgical focus: Video

E-ISSN

2643-5217

Volume

7

Issue

2

First Page

V3

PubMed ID

36425262

Digital Object Identifier (DOI)

10.3171/2022.7.FOCVID2258

Recommended Citation

Srinivasan, Visish M.; Hartke, Joelle N.; Catapano, Joshua S.; Winkler, Ethan A.; Jadhav, Ashutosh P.; Albuquerque, Felipe C.; and Ducruet, Andrew F., "Challenging access during flow diversion treatment of a giant cavernous ICA aneurysm" (2022). Translational Neuroscience. 2244.
https://scholar.barrowneuro.org/neurobiology/2244