1. Optical coherence tomography–guided flow diversion for aneurysmal treatment

    Optical coherence tomography–guided flow diversion for aneurysmal treatment

    A 28-year-old man presenting with right third nerve palsy was diagnosed with a giant unruptured aneurysm supplied by the right posterior communicating and cerebral arteries (figure 1, A and B). The aneurysm was treated with flow-diverting stent-assisted coiling. Two months later, he presented with new-onset left-sided weakness, and MRI showed increased edema in the thalamus (figure 1C) and increased aneurysm size and no filling. There was no evidence of stent malapposition with high-resolution cone-beam (VASO) CT (figure 2). Angiography and optical coherence tomography (OCT) imaging demonstrated no stent endothelialization over a patent portion of the aneurysm neck (figure 3). 1 ...

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