Failure of the Pipeline Embolization Device in PCOM Artery A
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Case

The first patient is a 67-year-old female who presented with Hunt and Hess grade (HHG) III subarachnoid hemorrhage. A right-sided external ventricular drain was placed followed by catheter angiogram that demonstrated a left PCOM aneurysm 14 × 10?mm with a fetal PCA. The fetal PCA arose from the sidewall of the aneurysm. We decided to proceed with endovascular intervention to secure the aneurysm ultraearly since the patient has a high HHG. An attempt to secure the aneurysm with stent-assisted coiling was unsuccessful. The decision was made to secure the aneurysm with a PED. A single PED was successfully deployed across the neck of the aneurysm. The patient made an excellent recovery and was discharged home after adequate hospital stay. She was placed on aspirin 325?mg daily, Plavix 75?mg daily. Follow-up angiogram at 3 months demonstrated a persistent full sized PCOM aneurysm with sluggish filling. The patient was admitted and underwent successful microsurgical clipping. She has now a Karnofsky performance status of 60.....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4812271/
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