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. 2022 Jan 6;12:801470. doi: 10.3389/fneur.2021.801470

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Copyright © 2022 Schob, Brill, Siebert, Sponza, Schüngel, Wohlgemuth, Götz, Mucha, Gopinathan, Scheer, Prell, Bohner, Gavrilovic and Skalej.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Indirect flow diversion for treatment of a partially thrombosed dissecting aneurysm of the right-hand side anterior inferior cerebellar artery in a 73-year-old patient. The perfused aneurysm (4.5 × 6.3 mm fundus, 2.0-mm neck) is 2.4 mm distant to the basilar artery. Upper row (A–C) magnetic resonance imaging of the incidental aneurysm compressing the pons. (A) Axial T2 weighted image showing the partially thrombosed aneurysm of the pre-meatal segment of the anterior inferior cerebellar artery lateral to the basilar artery. (B) Corresponding sagittal T2 weighted image demonstrating the mass effect of the aneurysm. (C) Axial T1 weighted image post Gadolinium showing the basilar artery, the perfused part of the aneurysm and the thrombosed portion. Middle row (D–F): Peri-interventional images. (D) Reconstruction of a 3D angiogram prior to treatment, showing the relationship between basilar artery, parent vessel, and aneurysm. (E) Contrast enhanced Xper-CT after implantation of a PED Flex Shield 4.75 × 14 mm into the basilar artery, jailing the aneurysm, bearing anterior-inferior cerebellar artery. (F) Postinterventional angiogram: aneurysmal perfusion is immediately altered (O'Kelly-Marotta Grade A3). The white lines indicate the proximal and distal endings of the implanted device. At the last available imaging study, 3 months post implantation, the aneurysm discretely decreased in size (not shown).