1. Department of Neurosurgery, Changhai Hospital, SMMU
Embolization of Wide-neck MCA Bifurcation Aneurysm using Dual Microcatheter and Flow Diversion Technique
Department of Neurosurgery, Changhai Hospital, SMMU

2. Case Report 55-year-Old Female Complaining of headache for 3 weeks
Intracranial aneurysm incidentally found by MRI 2 weeks before admission.
PE: Nothing significant

3. MR

4. CTA
Acom aneurysm
MCA bifurcation aneurysm, wide-neck, both trunks involved in the neck region

5. DSA MCA bifurcation aneurysm wide-neck
both trunks involved in the neck region

6. Dual Microcatheter tech.
Partially embolized

7. Dual Microcatheter tech.
Superior trunk
Inferior trunk
Patency of both trunks was maintained

8. Stent deployment
Microcatheter advanced through the acute angle between M1 & superior trunck to M2 under the support of coils in the dome.

9. Stent deployment
Rebar-18
Solitaire 4/20

10. Post-embolization Raymond II Both trunks of MCA patent Inferior trunk
Superior trunk
Inferior trunk
Inferior trunk
Raymond II
Both trunks of MCA patent

11. Flow diversion by stent
pre-embo.
post-embo.
Curvature between M1-M2 (superior trunk) decreased in the same working projection

12. Follow up angio.
2-month-follow up angio.

13. CFD
Pre-stenting
Post-stenting

14. CFD
Pre-stenting
Post-stenting