Treatment
Brain Aneurysm treated by Endovascular techniques
1st Stent-Assisted Coiling for Ruptured ICA Bifurcation Aneurysm at Neurosurgery Department, GEIMS
The Neurosurgery Department at GEIMS successfully performed its first stent-assisted coiling procedure on a 70-year-old female who presented with a ruptured internal carotid artery (ICA) bifurcation aneurysm. The patient arrived in critical condition with a subarachnoid hemorrhage, confirmed by CT imaging. Subsequent digital subtraction angiography (DSA) revealed a wide-necked ICA bifurcation aneurysm, making it unsuitable for standalone coiling .
Given the high risk of rebleeding and the complexity of the aneurysm anatomy, the team opted for an advanced stent-assisted coiling technique. Under general anesthesia, a self-expanding stent was deployed across the aneurysm neck to provide support for precise coil placement while maintaining the patency of the parent and branch vessels. Coils were successfully packed into the aneurysm sac, achieving near-complete obliteration without procedural complications.
Despite the challenges of managing a ruptured aneurysm in an elderly patient, the procedure was uneventful, and the patient was stabilized postoperatively. She was started on carefully monitored antiplatelet therapy to minimize stent-related complications. Follow-up imaging showed satisfactory aneurysm occlusion and good vascular flow.
This landmark case demonstrates the department’s capability to adopt advanced neuro-interventional techniques, offering innovative solutions for complex ruptured aneurysms and improving outcomes in high-risk patients.
