**2.5. CASE 5**

256 Aneurysm

**2.4. CASE 4** 

the aneurysm with patent ICA (Figure 8B).

**Figure 7.** CTA (A) and DSA (B) before endovascular treatment of an aneurysm of the left cervical

An 55-year-old male was admitted to our centre for endovascular treatment of a symptomatic dissecting aneurysm of the cervical segment of the ICA subsequent to a stroke. The patient was pre-medicated with 100 mg aspirin and 75 mg clopidogrel for 3 days before the endovascular procedure. Endovascular treatment was performed after gaining access via the right femoral artery and placement of a 6-F guiding sheath (Guider Softip™ XF, Boston Scientific Corp., Fremont, CA, USA) in the CCA. DSA confirmed the CTA findings of an aneurysm of the cervical segment of the ICA (Figure 8A). A 0.014 guidewire (Synchro, Boston Scientific Corp., Fremont, CA, USA) was passed distal to the aneurysm and a 5x26mm Jostent Graftmaster (Abbott Vascular, Abbott Park, Ill, USA) advanced over the wire and successfully deployed after balloon inflation. Control DSA confirmed exclusion of

**Figure 8.** DSA before (A) endovascular treatment of an aneurysm of the left cervical segment of the ICA

and angiogram after endovascular treatment with implantation of a covered stent (B).

segment of the ICA and final angiogram after implantation of a covered stent (C).

A 44-year-old female was referred to our hospital for treatment of an asymptomatic fusiform aneurysm at the intradural fourth segment of the right vertebral artery. Endovascular treatment was considered to be first-line treatment for this VA aneurysm. The patient received 100 mg aspirin and 75 mg clopidogrel for 3 days before the procedure. Left femoral access was used and a 6-F guiding catheter (Neuron, Penumbra Inc, San Leandro, California, USA) advanced to the V3 segment of the right VA. DSA confirmed fusiform aneurysm of the V4 segment of the VA (Figure 9A). After passage of a 0.014 guidewire (Synchro, Boston Scientific Corp., Fremont, CA, USA) distal to the aneurysm neck, a flow diverting device Silk ((Balt, Montmorency, France) was deployed. The aneurysm was excluded and this was demonstrated at control angiography with no filling of the aneurysm (Figure 9B).

**Figure 9.** DSA before (A) endovascular therapy of an aneurysm of the intradural segment of right vertebral artery and angiogram after implantation of flow diverting device (B).
