PT  - JOURNAL ARTICLE
AU  - David Dornbos III
AU  - Promod Pillai
AU  - Eric Sauvageau
TI  - Flow diverter assisted coil embolization of a very small ruptured ophthalmic artery aneurysm
AID  - 10.1136/neurintsurg-2013-010876.rep
DP  - 2016 Jun 01
TA  - Journal of NeuroInterventional Surgery
PG  - e2--e4
VI  - 8
IP  - e1
4099  - http://jnis.bmj.com/content/8/e1/e2.short
4100  - http://jnis.bmj.com/content/8/e1/e2.full
SO  - J NeuroIntervent Surg2016 Jun 01; 8
AB  - Small ruptured aneurysms present a unique problem to endovascular therapy. We report a case in which a patient presented with subarachnoid hemorrhage and a very small ruptured ophthalmic artery aneurysm, for which endovascular therapy was preferred secondary to severe cardiac comorbidities. Due to the aneurysm size, a small 1.5 mm coil was needed, but presented a significant risk of migration. Conventional stent assisted coiling was considered suboptimal as the small coil could have easily migrated through the strut. We present a novel technique of flow diverter assisted coil embolization in which a coil was placed within the aneurysm and a pipeline embolization device was then partially deployed, jailing the microcatheter and coil mass. Once in place, the coil was detached, securing the aneurysm, and preventing coil migration. Through the use of a flow diverter, some degree of aneurysm protection would still be expected in the event of coil migration toward the ophthalmic artery origin.