Distal Anchoring Technique

• A 79-year-old female presented to clinic with incidental finding of a R ACA aneurysm on workup for dizziness.
• PMH: HTN
• Social Hx: Previous smoker < 1PPD x 4y
• No family hx of intracranial aneurysms
• Exam: Neuro intact

Baseline Angiogram

Baseline Angiogram (3D)

Proximal Access

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• Flow diverter stent
  • 3 x 20 mm
• Support
  • 072, 044 support catheters
  • 027 delivery microcatheter
  • 014 microwire

Technical Challenge

• Around the world technique to gain distal access
• Microcatheter loop would not reduce

Distal Anchoring Technique

• 3 x 20 mm stent retriever deployed
  • Distal Anchor
• Microcatheter loop reduced

Complication

• Spasm – IA verapamil
• Distal outflow occlusion – IA + IV Aggrastat

Eclipse

Gateway

Devices used

• Guide: 7F long sheath
• Support: 072, 044 intermediate support catheters
• 027 microcatheter
• 3 x 20 stent-retriever
• Flow diverting stent 3 x 20 mm
• Balloons
  • 6 x 20 mm
  • 1.5 x 9 mm

Final Angiogram