"Cross-over" technique for horizontal stenting of an internal carotid bifurcation aneurysm using a new self-expandable stent: technical case report.
OBJECTIVE
To describe the use of a newly available self-expandable stent in a cross-over approach for treatment of a large, wide-necked carotid termination aneurysm.


METHODS
A 58-year-old hypertensive woman presenting with mild headaches underwent computed tomography, which showed a nonruptured aneurysm of the left internal carotid artery. She subsequently underwent cerebral angiography, confirming that the aneurysm was located at the left terminal carotid segment with a wide neck.


METHODS
Using a cross-over approach from the contralateral internal carotid artery, a new self-expandable stent was advanced through the anterior communicating artery and placed horizontally across the aneurysm neck. Aneurysm occlusion was performed by subsequent trans-stent catheterization of the aneurysm and coil packing.


CONCLUSIONS
Successful stent placement allowed subtotal coil occlusion of the aneurysm with a good anatomic and clinical result. No complications were encountered. The new self-expandable stent is a highly flexible, low-profile device that can be safely navigated through tortuous intracranial vessels even in a crossover technique. Its radial force and closed cell design is suitable for stent-assisted coiling and may be superior to stents with an open cell design.
Benndorf
Goetz
G
Department of Radiology, Baylor College of Medicine, The Methodist Hospital, Houston, Texas 77030, USA. benndorf@.bcm.tmc.edu
Klucznik
Richard P
RP
Meyer
Denise
D
Strother
Charles M
CM
Mawad
Michel E
ME
D000800:Angioplasty, Balloon / Q000379:methods; D002533:Cerebral Angiography / Q000379:methods*; D018592:Cross-Over Studies; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000628:therapy; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D015607:Stents