clinical center of neuroscience changhai hospital, smmu embolization of wide-neck mca bifurcation...
TRANSCRIPT
![Page 1: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/1.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
Embolization of Wide-neck MCA Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion Microcatheter and Flow Diversion
TechniqueTechnique
Department of Neurosurgery, Changhai Hospital, SMMU
![Page 2: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/2.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
Case Report
• 55-year-Old Female
• Complaining of headache for 3 weeks
• Intracranial aneurysm incidentally found by MRI 2 weeks before admission.
• PE: Nothing significant
![Page 3: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/3.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
MR
![Page 4: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/4.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
CTA
• Acom aneurysm
• MCA bifurcation aneurysm, wide-neck, both trunks involved in the neck region
![Page 5: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/5.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
DSA
MCA bifurcation aneurysm wide-neck both trunks involved in the neck region
![Page 6: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/6.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
Dual Microcatheter tech.
• Partially embolized
![Page 7: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/7.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
Dual Microcatheter tech.
• Patency of both trunks was maintained
Superior trunk
Inferior trunk Inferior trunk
Superior trunk
![Page 8: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/8.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
Stent deployment
• Microcatheter advanced through the acute angle between M1 & superior trunck to M2 under the support of coils in the dome.
![Page 9: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/9.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
Stent deployment
• Rebar-18
• Solitaire 4/20
![Page 10: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/10.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
Post-embolization
• Raymond II
• Both trunks of MCA patent
Superior trunk
Inferior trunkInferior trunk
![Page 11: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/11.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
Flow diversion by stent
• Curvature between M1-M2 (superior trunk)
decreased in the same working projection
pre-embo. post-embo.
![Page 12: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/12.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
Follow up angio.
• 2-month-follow up angio.
![Page 13: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/13.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
CFD
Pre-stenting Post-stenting
![Page 14: Clinical Center of Neuroscience Changhai Hospital, SMMU Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion](https://reader034.vdocuments.site/reader034/viewer/2022051417/5697c0291a28abf838cd7255/html5/thumbnails/14.jpg)
Clinical Center of Neuroscience Clinical Center of Neuroscience Changhai Hospital, SMMUChanghai Hospital, SMMU
CFD
Pre-stenting Post-stenting