Abstract
Objective and Importance To demonstrate the curative reconstruction of two giant fusiform aneurysms using
a combination of flow-diverter stents and self-expanding stents for intracranial use.
Clinical Presentation Two cases that would have been difficult to manage with standard methods: one patient
with deficiencies of cranial nerves VI and VII on the left, acute diplopia, and an
aneurysm of the vertebrobasilar bifurcation, the other with diplopia, deficiencies
of cranial nerves III and VI, and an aneurysm of the intracavernous internal carotid
artery.
Intervention or Technique Complete reconstruction was achieved using a combination of flow-diverter and self-expandable
stents. Follow-up investigations at 6 months demonstrated the complete reconstruction
of the arteries and angiographically determined disappearance of the aneurysms with
resolution of the clinical profile. The patients' outcome was excellent (modified
Rankin Scale: 0).
Conclusion This technique enables safe and definitive treatment of lesions that would be difficult
to manage with other methods. The greater metal surface does not seem to interfere
with the perforating arteries originating from the segments involved.
Keywords
flow-diverter stent - fusiform aneurysm - giant aneurysm - endovascular treatment
- endovascular neurosurgery - intracranial stent
