Horizontal deployment of the Enterprise stent to assist coil embolisation of wide-necked terminal aneurysms is feasible. This device can be navigated via relatively small communicating arteries, in cases with favourable anatomy. Early angiographic results were favourable; however, longer-term follow-up will be required.
A 51-year-old gentleman with no significant past medical history presented with a WFNS grade 1 subarachnoid haemorrhage. Initial angiographic investigations revealed no cause, but repeat tests showed a small basilar perforator aneurysm. Following a failed attempt at endovascular treatment, a craniotomy and excision of the aneurysm was performed. Post-operatively the patient made a good recovery. This case highlights the importance of delayed repeat catheter angiography in selected patients with suspicious initial CT head results.
We present our initial clinical experience of Dendron Variable Detachable System (VDS) coils, now Sapphire VDS from MTI, in the endovascular treatment of cerebral aneurysms. VDS coils, uniquely, can be detached at variable points along their length, allowing placement of as much or as little as desired of the coil within the aneurysm. Our ten patients formed part of a multicentre feasibility study. VDS coils were successfully deployed in all but one aneurysm. The electrolytic detachment mechanism with practice is both simple to use and reliable. The coils are however slightly stiffer than standard coils limiting their use in small aneurysms. This remains a technology in evolution.
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