| Pediatric Cerebral Aneurysms : Figure 1 |
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MR demonstrated a left mesial temporal mass lesion consistent with a partially thrombosed aneurysm involving the second and third segments of the left posterior
cerebral artery (Figure 1A, white arrow). Cerebral arteriography with 3-dimensional reconstructions confirmed the presence of a fusiform aneurysm measuring 21 x 15 x 10
mm involving the distal left posterior cerebral artery (Figure 1B). Given the child’s major co-morbidity of cystic fibrosis, aneurysm’s shape and location, we elected
to treat the patient using endovascular techniques. The aneurysm was obliterated with second generation, coated platinum coils. Using a 5 French (1.6 mm diameter) guiding catheter and high-resolution digital road-map imaging, a hair-like microcatheter was passed over a 0.014 inch microguidewire into the aneurysm. Occlusion of the aneurysm was performed using Matrix™ biologically-active coils. A total of 21 coils measuring 464 cm in overall length were deployed and resulted in complete occlusion of the aneurysm (Figure 1C-D, white arrows). Left common carotid arteriography following the treatment procedure demonstrated leptomeningeal collaterals (detour pathways for blood flow around the aneurysm) to the parietal branch of the left posterior cerebral artery beyond the aneurysm (Figure 1D, black arrowheads). |
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