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State-of-art technique and hands-on clinical experience come together as Prof. Laurent Spelle, assisted by Léon Ikka (France) and Soheil Naderi (Iran) treat a non-thrombosed giant (3 cm) right internal carotid aneurysm (ICA) in a 48-year-old female patient with balance disturbances and decreased left eye visual acuity. In the best LINNC tradition join us as this procedure – broadcast live during LINNC 2018 – unfolds, offering an in-depth discussion led by Prof. Jacques Moret and his expert panel, including questions from the audience. In this video, we can follow each step on two screens, one in real-time and the dedicated Sim&Cure simulation used by the operators. Discover the use of artificial intelligence (AI) “roadmapping” and its role in planning the procedure: from choosing the correct tools, visualizing the choices and assisting during the procedure to ensure the best placement of the chosen devices. Learn why flow diversion was seen to be “a superior strategy to flow occlusion”, with the final choice being flow diverter assisted coiling using a 30 mm Silk stent.
Our current clinical understanding of clots in relation to treating the aneurysm are reviewed. Prof. Moret and the panel discuss “mass effect”, the stability of clots or their inflammatory activity and they look at the role that potential thrombosis, proteolytic enzyme release or size play in choosing a coiling strategy: Should an aneurysm smaller than 10 cm be coiled? At what size do you choose to coil: 10? 12? 15 cms? Learn why one panelist says, “What we are observing in these coiled aneurysms is a biological process: if we like it, we call it healing, if we don’t like it, we call it inflammation.”
As we follow the procedure, we can pick up practical tips and tricks from these experienced specialists such as the nature of “pushing vs. unsheathing” or the use of a torquer… For all this and more, join us now….
This LIVE case corresponds to the highest ethical standards in medicine and is posted on LINNC Online for educational purposes only to allow medical professionals to improve their knowledge about these procedures and how to best treat their patients.
