Feasibility of Using Intravascular Ultrasonography for Assessment of Giant Cavernous Aneurysm after Endovascular Treatment: a Technical Report

Abstract

Introduction—Intravascular ultrasonography (IVUS) has been shown as a valuable adjunct imaging tool
during endovascular procedures but its value in detection of any recurrence during follow up after endovascular coil embolization of large and giant intracranial aneurysms is not reported.
Methods—A 41 years old man who had been treated using stent assisted coil embolization for cavernous
segment aneurysm of the left internal carotid artery underwent 60 month angiographic follow up. Concurrently, IVUS catheter was advanced under fluoroscopic guidance inside the cavernous portion of the left
internal carotid artery. Then IVUS images were used to visualize the stent, coil loops, and aneurysm neck.
Results—The angiographic images were limited because of superimposition of the aneurysm on the
parent vessel in all projections. IVUS images demonstrated that the stent was patent along its whole length
and there was no sign of stent deformity or in-stent thrombosis. Loops of the coil were visualized as hyperechoic signals inside the aneurysm and there was no sign of herniated loops of coil inside the stent.
Conclusion—In this case report, we observed that adjunct use of IVUS can provide valuable information
not ascertained by angiography during follow up assessment of coil embolized aneurysm.