Issues concerning the treatment of complex posterior circulation - - PowerPoint PPT Presentation

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Issues concerning the treatment of complex posterior circulation - - PowerPoint PPT Presentation

Dec 17, 2023 206 likes •868 views

Issues concerning the treatment of complex posterior circulation aneurysms with flow diversion devices P Kim Nelson NYU Langone Medical Center 11/13/2008 3/4/2008 17 year old male Pre-treatment angiogram Patient had remotely undergone

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Issues concerning the treatment of complex posterior circulation aneurysms with flow diversion devices

P Kim Nelson NYU Langone Medical Center

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3/4/2008 11/13/2008

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17 year old male

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Pre-treatment angiogram Patient had remotely undergone

  • cclusion of the right vertebral artery
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6 month follow-up angiogram

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Heterogeneity of aneurysms and patients

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Posterior circulation

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58 year old male with cranial neuropathies and quadraparesis

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8/31/09 10/5/09

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76 year old woman with paraparesis and diplopia

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Sequential images of construct fabrication Pre-treatment angiogram

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Immediate post-PED angio demonstrating delayed aneurysm washout

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24 hour post-treatment angio demonstrating interval progressive thrombosis of the aneurysm. Minor residual opacification of the proximal aneurysm at the left AICA outflow

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Massive IV/SAH 2 weeks post-treatment

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37 year old woman with swallowing disorder, right 6th and 7th N palsies, and trismus

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61 year old male (locked in syndrome)

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Treatment angiogram

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Follow-up angiogram

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60 year old male with multiple cranial neuopathies and quadraparesis

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Fusiform Basilar Artery Aneurysm

  • 25 year old right handed gentleman

presenting with acute onset of diplopia

  • Neurologic exam: significant for right sixth

nerve palsy.

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MRI

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Floating stent as endoluminal baffle

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Post-PED embolization LVA angiogram

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Post-PED embolization LVA angiogram

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Post-PED RVA 3 day follow-up angiogram

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Follow-up imaging 5 weeks post-treatment– Patient with worsening headaches

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MRI 7 months post-PED: Symptoms resolved

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Post-PED 12 month follow-up angiogram

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Post-PED 12 month follow-up RVA angiogram

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Post-treatment* survival among patients with fusiform basilar aneurysms

Time (months) Surviving patients *

1 12

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