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Salvage Neuroform stent-assisted coiling for recurrent giant aneurysm after waffle-cone treatment
  1. Erik F Hauck1,2,
  2. Sabareesh K Natarajan1,2,
  3. L Nelson Hopkins1,2,3,
  4. Elad I Levy1,2,3,
  5. Adnan H Siddiqui1,2,3
  1. 1Department of Neurosurgery, Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, USA
  2. 2Department of Neurosurgery, Millard Fillmore Gates Hospital, Kaleida Health; Buffalo NY, Buffalo, USA
  3. 3Department of Radiology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, USA
  1. Correspondence to Adnan H Siddiqui, University at Buffalo Neurosurgery, Millard Fillmore Gates Hospital, Kaleida Health, 3 Gates Circle, Buffalo, NY 14209, USA; asiddiqui{at}


We report a case of aneurysm progression after waffle-cone treatment. A patient in their seventies presented with headaches. Four years earlier, this individual had undergone waffle-cone treatment of a giant ruptured left ophthalmic aneurysm. Angiography demonstrated aneurysm growth. A second stent was deployed through the initially placed stent to recreate the aneurysm neck and to provide support for stent-assisted coiling. The residual aneurysm was coiled with good outcome.

  • Coil
  • endovascular
  • giant aneurysm
  • intracranial stent
  • recurrence
  • waffle cone
  • aneurysm
  • stent
  • technique

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  • Competing interests Dr Hopkins receives research study grants from Abbott (ACT 1 Choice), Boston Scientific (CABANA), Cordis (SAPPHIRE WW) and ev3 (CREATE) and a research grant from Toshiba (for the Toshiba Stroke Research Center); has an ownership/financial interest in AccessClosure, Boston Scientific, Cordis, Micrus and Valor Medical; serves on the Abbott Vascular Speakers' Bureau; receives royalties from Cordis (for the AngioGuard device) and honoraria from Bard, Boston Scientific, Cordis and from the following for speaking at conferences: Complete Conference Management, Cleveland Clinic and SCAI; serves as a consultant to or on the advisory board for Abbott, AccessClosure, Bard, Boston Scientific, Cordis, Gore, Lumen Biomedical, Micrus and Toshiba; serves as the conference director for Nurcon Conferences/Strategic Medical Seminars LLC. Dr Levy receives research grant support (principal investigator: Stent-Assisted Recanalization in acute Ischemic Stroke, SARIS), other research support (devices), and honoraria from Boston Scientific and research support from Micrus Endovascular and ev3; has ownership interests in Intratech Medical Ltd and Mynx/Access Closure; serves as a consultant on the board of Scientific Advisors to Codman Neurovascular/Cordis Corporation; serves as a consultant per project and/or per hour for Micrus Endovascular, ev3 and TheraSyn Sensors, Inc.; receives fees for carotid stent training from Abbott Vascular and ev3. Dr Levy receives no consulting salary arrangements. All consulting is per project and/or per hour. Dr Natarajan is the recipient of the 2010–2011 Cushing Award of the Congress of Neurological Surgeons. Dr Siddiqui has received research grants from the University at Buffalo and from the National Institutes of Health (NINDS 1R01NS064592-01A1, Hemodynamic induction of pathologic remodeling leading to intracranial aneurysms); is a consultant to Codman Neurovascular/Cordis Corporation, Concentric Medical, ev3 and Micrus Endovascular; serves on speakers' bureaux for Codman Neurovascular/Cordis Corporation and Genentech; has received honoraria from Genentech, Neocure Group LLC, American Association of Neurological Surgeons' courses, and an Emergency Medicine Conference and from Codman Neurovascular/Cordis Corporation for training other neurointerventionists. Dr Siddiqui receives no consulting salary arrangements. All consulting is per project and/or per hour. Dr Hauck has no disclosure information to report.

  • Ethics approval This study was conducted with the approval of the University at Buffalo Institutional Review Board.

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