CT angiography for assessment of intracranial basilar apex aneurysm neck diameter reduction poststenting for treatment planning.
OBJECTIVE
Once a contraindication for a neuro-interventional therapeutic approach, some wide-necked aneurysms can now be treated with stent assistance. Radiologically assessing the impact of a stent on the neck of a wide-neck bifurcation, aneurysm remains a challenge however.


METHODS
A 76-year-old female with a large irregular basilar apex aneurysm was referred for endovascular treatment. Angiographic imaging revealed a basilar apex aneurysm with a 6-mm neck and a 14-mm dome. The decision was made to perform staged stent-assisted coiling of the aneurysm. In the interim time, although the stent was allowed to heal in place, a CTA was done to assess the positioning of the stent and the degree of neck narrowing.


RESULTS
The CTA showed that the neck had been narrowed from 6 to 2 mm hence making endovascular coiling feasible.


CONCLUSIONS
Our case illustrates the use of CTA poststent deployment to visualize the change in aneurysm neck caliber precoil embolization.
Adel
Joseph G
JG
Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
Sherma
Arun K
AK
Bendok
Bernard R
BR
D000368:Aged; D002533:Cerebral Angiography / Q000379:methods*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D018579:Patient Selection; D011237:Predictive Value of Tests; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome