Cerebral Aneurysms : Figure 1

A, 58 year old woman with chronic hypertension, sinusitis, and a long smoking history developed worsening headaches and was found to harbor an 11 mm aneurysm of the basilar artery terminus (arrow). B, arteriographic evaluation including rotational arteriography with 3-dimensional reconstructions permits pre-operative endovascular treatment planning. In a multi-disciplinary team paradigm, treatment options including craniotomy with surgical clipping or endovascular coil occlusion were discussed with the patient. C, Under general anesthesia, a microcatheter measuring 0.67 mm diameter is guided into the aneurysm from the femoral artery using high resolution roadmap imaging and the aneurysm is progressively occluded using special aneurysm coils (arrow), in this case a combination of GDC and “second generation” biologically-active coils were used. D, Surveillance arteriography at 6 months demonstrates complete occlusion of the aneurysm (arrow) and no new aneurysm in other aspects of the cerebral circulation.