Masterclass #1: What is the gender of ACom Aneurysms: Sidewall? Bifurcation? Mixed? Its impact on flow-diversion management

Saleh LAMIN, Giuseppe LANZINO, Jacques MORET, Laurent SPELLE

When treating an ACom aneurysms, knowing what kind of aneurysm it is can have an impact on how you choose to treat and the outcome of your treatment. As Prof. Laurent Spelle says “If you don’t succeed, it is probably because you don’t understand” and in this first LINNC Masterclass, Professors Jacques Moret and Laurent Spelle provide the foundations for understanding successful flow diversion in carefully chosen clinical settings.

How would you routinely treat ACom aneurysms?  Flow diverters?

• Are there viable alternatives today to flow diversion in treating these aneurysms or has flow diversion arrived at a new maturity and become the preferred choice?

How are outcomes affected by the difference in size between the two A1 arteries?

• Consider what happens when the left and right A1 are equal in size, when there is a slight discrepancy in size…or when one side is far more prominent than the other.
• How does this affect the strategy chosen?
• How could this impact the changes in flow after treatment?

Should you cover the neck of the aneurysm when you flow divert? Beyond the true flow diverter effect, how does changing the angle of the arterial complex affect the long-term effectiveness of the treatment? When deploying a flow diverter along a curve, what does it mean “to be balanced” and why is this important?

How long does it take for an aneurysm to disappear after using flow diversion? Do you know how to use the radial rather than femoral approach in flow diversion?

In Case 3, you’ll see how…following step by step in the cath lab with a special guest operator - an international expert with experience in using the radial approach.

Join Professors Moret and Spelle along with their panel of international experts as they explore each of the specially chosen cases to provide insight and broadening our understanding of Acom aneurysms and their management.