Quantitative Computed Tomographic Volumetry after Treatment of a Giant Intracranial Aneurysm with a Pipeline Embolization Device.
Recently developed flow diverters, such as the pipeline embolization device (PED), allow for safe and efficacious treatment of giant intracranial aneurysms, with high occlusion rates and a low incidence of complications. However, incomplete obliteration after PED treatment may lead to aneurysm regrowth and delayed rupture. Herein, we report a case of a partially thrombosed giant aneurysm of the cavernous internal carotid artery that showed progressive recanalization at 1-3 months after application of a PED. We monitored inflow volume in the aneurysm by computed tomographic angiography (CTA) and computed tomographic volumetric imaging (CTVI). Based on the imaging results, rather than applying additional PED, we decided to make the switch from a dual antiplatelet medication to low-dose aspirin alone at 3 months after the treatment; complete obliteration of the aneurysm was noted at 21 months. Similar to the findings in this unusual case, CTA and CTVI may be useful follow-up methods for optimal management of patients with giant intracranial aneurysms after PED treatment.
Department of Radiology, Chung-Ang University Hospital, Seoul, Korea.
Woong Jae
WJ
Lee
Department of Radiology, Chung-Ang University Hospital, Seoul, Korea. flightdr61@cau.ac.kr.
Jun Soo
JS
Byun
Department of Radiology, Chung-Ang University Hospital, Seoul, Korea.
Jae Kyun
JK
Kim
Department of Neurosurgery, Chung-Ang University Hospital, Seoul, Korea.
Taek Kyun
TK
Nam
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015607:Stents; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
Intracranial aneurysm; angiography; computed tomography; medical device; therapeutic embolization