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Acutely ruptured basilar artery bifurcation aneurysm, treated with simultaneous Cascade and Comaneci temporary-assisted coiling
  1. Alexander Sirakov1,
  2. Radoslav Raychev2,
  3. Pervinder Bhogal3,
  4. Stanimir Sirakov1
  1. 1 Radiology Department, University Hospital Saint Ivan Rilski, Sofia, Bulgaria
  2. 2 Neurology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
  3. 3 Interventional Neuroradiology, Royal London Hospital, London, UK
  1. Correspondence to Dr Stanimir Sirakov, Radiology Department, University Hospital Saint Ivan Rilski, Sofia 1431, Bulgaria; ssirakov{at}


Temporary stent-assisted coiling is an eligible approach for the treatment of acutely ruptured complex cerebral aneurysms. Improved material properties and industrial advances in braiding technology have led to the introduction of new stent-like devices to augment endovascular coil embolization. Such technology includes the Cascade and Comaneci neck-bridging devices. Both devices are manually controlled, non-occlusive and fully retrievable neck-bridging temporary implants. The braided nature and the ultra-thin wire, compliant structure of their bridging meshes helps maintain target vessel patency during coil embolization. In this video (video 1) we demonstrate the straightforward combination of two temporary neck-bridging devices for the embolization of an acutely ruptured aneurysm of the basilar artery. Technical success and complete embolization of the aneurysm were recorded at the final angiography. In this technical video we discuss the technical nuances of the Comaneci and Cascade coil embolization.

Video 1
  • aneurysm
  • coil
  • device

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  • Contributors AS, SS: case performance, video creation. PB, RR: final review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethics Committee of University Hospital Saint Ivan Rilski approved on 06.05.2019 (ID: 314/06.05.2019) the information consent, including permission to use the data in scientific papers. All patient data are anonymized.

  • Provenance and peer review Not commissioned; externally peer reviewed.