Dr Vipul GuptaMedanta-The MedicityGurgaon, India

A B

Fig. 1 A & B – DSA (A) with 3D reconstruction (B) shows a fusiform aneurysm involving left MCA bifurcation particularly the lower division.

Dissecting MCA Aneurysm

C & D - Road map images showing a micro catheter being navigated to lower division of MCA. E – Stent deployment in lower division of MCA. F- DSA after coil placement showing almost complete occlusion.

C D

E F

A B

CD

Fig. 2 A- Follow-up Angiogram revealing growth of residual aneurysm. B & C – 3D angiography. B – overlap of coil mass (orange) and the recurrent aneurysm seen. C- By changing the angulation the neck of the recurrent aneurysm could be profiled. D – Road map image showing tip of coiling microcatheter at the neck of the aneurysm.

E

E – Post coiling angiogram showing complete occlusion. F – Native image showing the coil mass.

F

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