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. 2011 Apr 18;17(1):36–48. doi: 10.1177/159101991101700107

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Copyright © 2011, Centauro S.r.l.

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A-G The patient with the left middle cerebral artery (MCA) aneurysm (patient no. 1) had been operated on 2 months previously and could not be clipped: Digital subtraction angiography shows the wide-neck MCA aneurysm (A). The first Enterprise stent (Neuroform3 stent could not be placed) lies between the inferior truncus and the proximal part of the MCA (black arrows in B). While trying to cross the first stent to deploy the second stent (Enterprise), the first stent protruded into the aneurysm, so proximal and distal markers of the first stent migrated (black arrows show the first and white arrows show the second stent markers in C). Aneurysm was intentionally not packed fully due to the protrusion of the stent into the aneurysm (D). This patient stopped taking the antiaggregant drugs (aspirin and clopidogrel) after 2 months and applied to the hospital because of severe headache and speaking problems. The cranial computed tomography showed acute temporal lobe infarction on the left (not shown). The occlusion of the inferior truncus of the left MCA was seen on angiography (E). Residual filling was also seen in the neck of the aneurysm. On DSA performed in the 11^th month (F), the aneurysm was totally closed and there was no restenosis in the stent lying between the proximal part and the superior truncus of the MCA. Magnetic resonance imaging with the FLAIR sequence showed gliotic and cystic changes consistent with chronic infarction of the left temporal and occipital lobes (G) due to the occlusion of the inferior trunk of the MCA.

A-G The patient with the left middle cerebral artery (MCA) aneurysm (patient no. 1) had been operated on 2 months previously and could not be clipped: Digital subtraction angiography shows the wide-neck MCA aneurysm (A). The first Enterprise stent (Neuroform3 stent could not be placed) lies between the inferior truncus and the proximal part of the MCA (black arrows in B). While trying to cross the first stent to deploy the second stent (Enterprise), the first stent protruded into the aneurysm, so proximal and distal markers of the first stent migrated (black arrows show the first and white arrows show the second stent markers in C). Aneurysm was intentionally not packed fully due to the protrusion of the stent into the aneurysm (D). This patient stopped taking the antiaggregant drugs (aspirin and clopidogrel) after 2 months and applied to the hospital because of severe headache and speaking problems. The cranial computed tomography showed acute temporal lobe infarction on the left (not shown). The occlusion of the inferior truncus of the left MCA was seen on angiography (E). Residual filling was also seen in the neck of the aneurysm. On DSA performed in the 11^th month (F), the aneurysm was totally closed and there was no restenosis in the stent lying between the proximal part and the superior truncus of the MCA. Magnetic resonance imaging with the FLAIR sequence showed gliotic and cystic changes consistent with chronic infarction of the left temporal and occipital lobes (G) due to the occlusion of the inferior trunk of the MCA.