choltgraver
Guest
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RADIOGRAPHIC FINDINGS AND INTERPRETATION:* *
1. Right common femoral artery oblique angiography centered over the right groin demonstrates puncture site above the level of bifurcation without evidence of iatrogenic injury to the vessel.
2. Right internal carotid artery AP and lateral views centered over the cervical portion of vessel demonstrates normal cervical anatomy.
3. Right internal carotid artery AP and lateral views centered over the cervical portion of vessel, followup angiogram after exchange and placement of the Neuron MAX guide catheter demonstrates that the guide is in good position in the proximal portion of the right internal carotid artery.
4. Right internal carotid artery AP and lateral magnified working angle views centered over the intracranial circulation demonstrates that a 9.5 mm wide neck dorsal IC aneurysm and a 2.5 mm paraophthalmic artery aneurysm.
5. Right internal carotid artery AP and lateral magnified working angle views centered over the aneurysm followup angiogram #1 after placement of the 1st number coil into the aneurysm demonstrates coil was in good position without evidence of any thromboembolic or hemorrhagic complication.
6. Right internal carotid artery AP and lateral magnified working angle views centered over the aneurysm followup angiogram #2 after placement of the 2nd coil demonstrates that both coils were in good position with within the aneurysm there was still filling in the aneurysm.
7. Right internal carotid artery AP and lateral magnified working angle views followup angiogram #3 after positioning the microcatheter into the right MCA demonstrates that there is a herniation and there was a coil prolapse into the parent vessel.* There was good flow without evidence of any thromboembolic complications.
8. Right internal carotid artery AP and lateral magnified working angle views followup angiogram #4 after removal of the SL-10 catheter and placement of the Phenom microcatheter to the MCA demonstrates again herniation of coil into the parent vessel.* No evidence of thromboembolic or hemorrhagic complication.* No evidence of any other vessel injury.
9. Right internal carotid artery AP and lateral magnified working angle views followup angiogram #5 after deployment of the Pipeline device demonstrates that the Pipeline is open, well apposed to the vessel wall and covering both the internal carotid artery aneurysms.
10. Right internal carotid artery AP and lateral branch views centered over the intracranial circulation demonstrated there was no evidence of branch occlusion, status post Pipeline and coil embolization of the right-sided internal carotid artery aneurysms.
11. Right common carotid artery AP and lateral views centered over the cervical portion of vessel followup angiogram after removal of guide catheter demonstrates no evidence vasospasm or iatrogenic injury to the common or the cervical carotid artery.
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RADIOGRAPHIC FINDINGS AND INTERPRETATION:* *
1. Right common femoral artery oblique angiography centered over the right groin demonstrates puncture site above the level of bifurcation without evidence of iatrogenic injury to the vessel.
2. Right internal carotid artery AP and lateral views centered over the cervical portion of vessel demonstrates normal cervical anatomy.
3. Right internal carotid artery AP and lateral views centered over the cervical portion of vessel, followup angiogram after exchange and placement of the Neuron MAX guide catheter demonstrates that the guide is in good position in the proximal portion of the right internal carotid artery.
4. Right internal carotid artery AP and lateral magnified working angle views centered over the intracranial circulation demonstrates that a 9.5 mm wide neck dorsal IC aneurysm and a 2.5 mm paraophthalmic artery aneurysm.
5. Right internal carotid artery AP and lateral magnified working angle views centered over the aneurysm followup angiogram #1 after placement of the 1st number coil into the aneurysm demonstrates coil was in good position without evidence of any thromboembolic or hemorrhagic complication.
6. Right internal carotid artery AP and lateral magnified working angle views centered over the aneurysm followup angiogram #2 after placement of the 2nd coil demonstrates that both coils were in good position with within the aneurysm there was still filling in the aneurysm.
7. Right internal carotid artery AP and lateral magnified working angle views followup angiogram #3 after positioning the microcatheter into the right MCA demonstrates that there is a herniation and there was a coil prolapse into the parent vessel.* There was good flow without evidence of any thromboembolic complications.
8. Right internal carotid artery AP and lateral magnified working angle views followup angiogram #4 after removal of the SL-10 catheter and placement of the Phenom microcatheter to the MCA demonstrates again herniation of coil into the parent vessel.* No evidence of thromboembolic or hemorrhagic complication.* No evidence of any other vessel injury.
9. Right internal carotid artery AP and lateral magnified working angle views followup angiogram #5 after deployment of the Pipeline device demonstrates that the Pipeline is open, well apposed to the vessel wall and covering both the internal carotid artery aneurysms.
10. Right internal carotid artery AP and lateral branch views centered over the intracranial circulation demonstrated there was no evidence of branch occlusion, status post Pipeline and coil embolization of the right-sided internal carotid artery aneurysms.
11. Right common carotid artery AP and lateral views centered over the cervical portion of vessel followup angiogram after removal of guide catheter demonstrates no evidence vasospasm or iatrogenic injury to the common or the cervical carotid artery.
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