THE FIRST EVER NEUROINTERVENTION CASE AT THE TERTIARY CARE KALAINGAR CENTENARY SUPER SPECIALITY GOVERNMENT HOSPITAL, CHENNAI, TAMIL NADU, INDIA.
30 year old lady presenting with collapse and low gcs, evaluated and found to have small basal cisternal SAH and a large basilar tip aneurysm. She was managed conservatively to begin with and was referred for treatment 6 weeks post ictus when she improved to GCS 13.
DSA showed a large wide-necked bilobed basilar tip aneurysm. The left p1 was incorporated in the aneurysm sac. The left pcom was dominant.
Challenge was accessing right PCA which I achieved looping the syncro14 exchange length along the aneurysm sac and doing a sim technique to enter the right PCA. SL10 was initially tracked along and after undoing the loop exchanged with XT27.
A surpass evolve flow-diverting stent 3.25 x 25 mm was deployed from right PCA to basilar whilst jailing a SL10 in the aneurysm sac which was used to deliver few long 360 soft coils. (Would have packed but for cost constraints).
Final angiography showed optimal FD placement and good early stasis within the aneurysm. No new neurology post procedure and she is on her road to recovery.
