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ACOM Aneurysm

Live Case Transmission From Medanta - The Medicity Hospital, Gurugram, India

Last update on June 2, 2026

Presented during LINNC Paris 2026 by Dr. Gaurav Goel and team, this live case demonstrates the complex endovascular management of an anterior communicating artery (ACOM) aneurysm.

Clinical Presentation & Strategic Decision-Making

The session features an 80-year-old male with a 2-year history of left trigeminal neuralgia, whose 8.35 mm aneurysm was incidentally detected on MRI and confirmed via CTA. The case presents a significant anatomical challenge due to a complex trifurcation, with the left pericallosal and callosal marginal arteries arising separately from the sac. To exclude the lesion while preserving these critical branches, the team opts for an intrasaccular flow disruption strategy.

Key technical highlights and expert panel debates

  • Access & navigation: Establishing distal support using a long Infinity sheath and a 115 cm CAT 5 guide catheter.
  • Microcatheter positioning: Navigating the anatomy with a Headway 21 / XT 27 microcatheter combination and a Synchro .014 microwire.
  • Intrasaccular flow disruption: Deploying a Contour device to disrupt flow, with a panel debate on sizing and device behavior at trifurcations where branches originate directly from the sac.

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Come and join us across the globe
LINNC Paris 2027 LINNC China 2026 LINNC Seminar 2026 - Asia Edition LINNC Seminar 2027 - Americas Edition
 Founded by Pr. Jacques Moret