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. 2019 May 14;11(12):1227–1234. doi: 10.1136/neurintsurg-2019-014840

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© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Flow diverter stent implantation for elective hemodynamic treatment of a distal (A3) aneurysm in the anterior circulation in a patient with a history of subarachnoid hemorrhage due to a ruptured anterior communicating artery aneurysm. The upper row shows the three-dimensional angiogram, the corresponding conventional digital subtraction angiography (DSA) image in working projection and intra-aneurysmal flow quantification (employing two-dimensional vector-based imaging), revealing short lasting turbulent flow in the aneurysm originating from the proximal pericallosal artery. The middle row shows the implanted Silk Vista Baby stent (2.25×15 mm, arrow), the immediate reduction of aneurysmal influx in vector-based imaging (reduced influx and decreased flow velocity in comparison with the pretreatment image), and the strongly diminished opacification of the aneurysm in the conventional DSA image. The bottom row shows maintained normal perfusion of the hemisphere including the parenchyma from the treated vessels.