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Take a look at Vladimir Kalousek interesting case which focuses on a specific occlusion scale: the Bicetre Occlusion Scale Score (BOSS).
In this clinical case, the CT does not show signs of subarachnoid hemorrhage (SAH). Lumbar punction for blood is negative. Basilar tip aneurysm is noticed on NCCT which was confirmed by MSCTA.
Considering the shape of the aneurysm, the location and the measurement of the diameters, we opt to implant a WEB device in form of 9x7mm, using the +1/-1 strategy.
By our hospital protocol, we also place WEB cases on double AA a few days before, and one month after.
The procedure is performed by right FA, placing a neuronmax GC into left VA, then via 27 is brought into the aneurysm, followed by deploying of WEB.
Also, our angio protocol consists of 20 minutes waiting after WEB devices flow diverters deployment to see possible intrastent thrombus forming or thrombus layer on the WEB edge.
After twenty minutes, we do a control run, which shows BOSS occlusion type 0’.
The patient is discharged few days after.
