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. 2021 Jul 8;32(2):491–498. doi: 10.1007/s00062-021-01053-x

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© The Author(s) 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 4 — Female patient with an incidental right paraophthalmic ICA aneurysm. a Periinterventional planning 3D-rotational angiogram demonstrated the wide-necked, trilobulated morphology of the aneurysm. b A Synchro 0.014in. microwire (white dashed arrow) was navigated across the aneurysm. c–e Due to the lacking support of a single microwire and stiffness of the XT-27 microcatheter the catheter bulged into the aneurysm sac, and due to the off-set between the microwire and the tip of the microcatheter (black arrow) was stuck on the ledge (white arrow) between the aneurysm neck and the parent artery preventing to be advanced distally. A Transend 0.010in. microwire (black dashed arrow) was then introduced into the XT-27 in parallel to the Synchro 0.014in providing more support for the microcatheter to be advanced past the aneurysm and positioned distally. A Surpass Evolve (Stryker Neurovascular, Fremont, CA, USA) was subsequently deployed. The cone beam CT (not shown) demonstrated some fish-mouthing at the proximal end of the FD. f A Neuroform Atlas stent was then deployed to improve wall apposition in the proximal part of the FD