Application of Optical Frequency Domain Imaging to Recanalized Unruptured Internal Carotid Artery Aneurysm Treated by Flow-Diverting Stent-Assisted Coiling

World Neurosurg. 2021 Feb:146:1-5. doi: 10.1016/j.wneu.2020.09.037. Epub 2020 Sep 12.

Abstract

Background: Here we report the application of optical frequency domain imaging (OFDI), a new optical coherence tomography device, for intravascular visualization in the treatment of a recanalized unruptured internal carotid artery aneurysm that was treated initially by stent-assisted coil embolization.

Case description: OFDI revealed malapposition of the stent and lack of neointimal growth at the aneurysm neck, which was treated by deployment of a Pipeline Embolization Device to overlap the stent. An angiogram performed 1 year after the procedure revealed perfect healing of the aneurysm, and OFDI clearly demonstrated good stent apposition and total endothelialization over the aneurysm neck.

Conclusions: OFDI/OCT appears to be a useful diagnostic tool for evaluating stent-strut apposition over the vessel wall and the grade of neointimal endothelialization across the neck of the aneurysm in aneurysmal recanalization.

Keywords: Flow diverter; Intracranial aneurysm; Neointimal endothelialization; Optical frequency domain imaging; Stent-assisted coil embolization.

Publication types

  • Case Reports

MeSH terms

  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / therapy
  • Carotid Artery, Internal / diagnostic imaging*
  • Embolization, Therapeutic / methods
  • Endovascular Procedures / methods
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / therapy*
  • Middle Aged
  • Neuroimaging / instrumentation
  • Neuroimaging / methods*
  • Stents
  • Tomography, Optical Coherence / instrumentation
  • Tomography, Optical Coherence / methods*