Abstract Background Intracranial aneurysms in children and adolescents are uncommon; they account for 0.5% to 4.6% of the total intracranial aneurysms cases. Methods A 15-year-old boy presented with ...a 6-month history of occipital headache that worsened over time. A magnetic resonance imaging scan revealed a giant, fusiform aneurysm of the V4 segment of the right vertebral artery with mass effect but no signs of hemorrhage. This lesion was confirmed by the catheter digital subtraction angiography. The posterior inferior cerebellar artery arose from the distal part of the aneurysm. Two flow-diverter devices were implanted in the V4 segment of the right vertebral artery. Follow-up angiograms performed 1 and 2 years after the procedure revealed a total aneurysm occlusion. Conclusion Flow-diverter device implantation may be a viable alternative to parent artery occlusion in a symptomatic, giant, fusiform vertebral artery aneurysm in a child.
Abstract Background/Objective PulseRider ® is a new endovascular stent dedicated to treat bifurcation intracranial aneurysms with a wide neck. Our purpose is to evaluate 6-months clinical and ...anatomical results of the device when used to facilitate endovascular coiling of wide-neck bifurcation aneurysms. Methods Unruptured intracranial aneurysms coiled with PulseRider ® , in 6 European centers and 1 US center, were retrospectively reviewed from June 2014 to October 2015. Immediate and 6-months results were evaluated independently by using the Raymond classification scale. Recanalization was defined as worsening, and progressive thrombosis was defined as improvement on the Raymond scale. Results Nineteen patients (10 women, 9 men; mean age, 63 years) harboring 19 bifurcations aneurysms (mean dome size, 8.8 mm; mean neck size, 5.8 mm) were included. Immediate angiographic outcome showed 11 complete aneurysm occlusions, 6 neck remnants, and 2 residual aneurysms. Follow-up at 6 months, obtained in all patients, included 12 complete aneurysm occlusions (63.1%), 6 neck remnants (31.6%), and 1 residual aneurysm (5.3%). Adequate occlusion (defined as complete occlusion and neck remnant combined) was observed in 94.7%. Progressive thrombosis was observed in 2 cases (10.6%) and recanalization in 1 case (5.3%). There was no in-stent stenosis or jailed branch occlusion. No bleeding was observed during the follow-up period. Permanent morbidity rate was 5.3% (1/19), and the mortality rate was 0% at 6 months. Conclusions The PulseRider ® allows endovascular treatment of wide-neck bifurcation intracranial aneurysms. Larger series are needed to confirm our preliminary results.