Partially Clipped Intracranial Aneurysm Obliterated with Combined Stent and Coil Implantation

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Abstract
Purpose: To report a case of endovascular stent placement to assist stable coil deployment in a symptomatic, wide-necked, partially clipped aneurysm. Case Report: A 48-year-old woman presented for endovascular treatment of a symptomatic posterior communicating artery aneurysm remnant that was surgically clipped 10 years ago. A 3.5-mm × 12-mm balloon-expandable stent was placed across the aneurysm orifice followed by complete obliteration of the remnant with coils implanted through the stent mesh. Digital subtraction angiography documented continued patency of the arterial lumen and complete obliteration of the aneurysm at 11 months. Conclusions: Partial aneurysm clipping may assist or complicate secondary interventional procedures and interfere with correct visualization of the neck. Stent placement obviates the need for the balloon-assist method of coil embolization for wide-necked aneurysm remnants, acting as a mechanical barrier to hold the coils in a very unfavorable anatomy.