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.
Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
Joseph G
JG
Adel
Arun K
AK
Sherma
Bernard R
BR
Bendok
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