title: A Novel Configuration of Pipeline Embolization Device for Internal Carotid Bifurcation Region Aneurysms: Horizontal Deployment.
abstract: OBJECTIVE
  To describe a novel configuration of pipeline embolization device for internal carotid bifurcation region aneurysm, named horizontal stenting.
  
  
  METHODS
  A 64-year-old woman, with visual deficit, harboring a large wide-necked aneurysm located at the junction between left internal carotid artery and left A1 segment of anterior cerebral artery, was submitted to endovascular treatment. As she had pre-existing occlusion of left internal carotid, approach from the contralateral internal carotid was used to advance the pipeline embolization device through the anterior communicating artery and place the flow diverter horizontally across the neck (from M1 to A1). Coil embolization was also performed through a microcatheter navigated via posterior communicating artery. The intervention was uneventful, with total aneurysm occlusion. Patient presented with visual improvement on follow-up.
  
  
  CONCLUSIONS
  Horizontal deployment of pipeline embolization device appears to be an acceptable and feasible alternative to treat internal carotid bifurcation aneurysms. Long-term follow-up and a greater number of cases are mandatory to establish the safety of this strategy.
authors.affiliation: Division of Interventional Neuroradiology, Hospital Felício Rocho, Rua Timbiras 3616, Barro Preto, Belo Horizonte, Minas Gerais, Brazil. felipepadovani@yahoo.com.br.
authors.forename: F P
authors.initials: FP
authors.lastname: Trivelato
authors.affiliation: Division of Interventional Neuroradiology, Hospital Felício Rocho, Rua Timbiras 3616, Barro Preto, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: J F S
authors.initials: JF
authors.lastname: Araújo
authors.affiliation: Division of Interventional Neuroradiology, Hospital Felício Rocho, Rua Timbiras 3616, Barro Preto, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: M T
authors.initials: MT
authors.lastname: Salles Rezende
authors.affiliation: Division of Interventional Neuroradiology, Hospital Felício Rocho, Rua Timbiras 3616, Barro Preto, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: A C
authors.initials: AC
authors.lastname: Ulhôa
mesh_terms: D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome
keywords: Aneurysm; Embolization; Stenting