Case Studies

Stenosis of the right intracranial vertebral artery

A 67-year-old lady presented with recurrent posterior circulation strokes in spite of medical management including double anti-platelet agents. She had stenosis of the right intracranial vertebral artery which was dominant and stenosis of a very small hypoplastic left vertebral. 3D angiography showed a much more severe disease with a badly dissected plaque than seen on DSA. We performed angioplasty and stenting successfully. A trans radial route with the distal placement of guiding was done for control in tortuous anatomy. The case emphasises the role of high-resolution 3D imaging in understanding the pathophysiology of intracranial stenosis.

Coiling small ruptured aneurysm

Small ruptured aneurysms can be challenging to coil, with a higher reported procedural rupture rate. Posterior pointing ACOM are particularly difficult to catheterise because of the need for a catheter to take a turn at the neck of the aneurysm. In this case, we used techniques of reverse-shaped microcatheter, wire torquing of catheter and use of coil loop to enter the aneurysm in such cases. In the end, good occlusion with complete control.

Giant ICA Aneurysm: flow diverter treatment

1.Techniques In Crossing The Aneurysm and Deployment of Flow Diverter

2.Use of 3D,XPER CT, VASO CT in Procedure.

Sector 51, Gurgaon ,
Haryana 122001, India
+91-9810332224 drvipulgupta25@gmail.com