Volume 98, Pages 879.e1-879.e4 (February 2017)

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Volume 98, Pages 879.e1-879.e4 (February 2017) Coiling of a Ruptured Large Internal Carotid Artery Aneurysm via Extracranial- Intracranial Saphenous Vein Bypass Graft Just After Proximal Ligation of the Internal Carotid Artery Hayato Tajima, Yoshio Araki, Takashi Izumi, Masahiro Nishihori, Sho Okamoto, Toshihiko Wakabayashi World Neurosurgery Volume 98, Pages 879.e1-879.e4 (February 2017) DOI: 10.1016/j.wneu.2016.11.066 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 1 (A) Three-dimensional digital subtraction angiography reveals the aneurysmal broad neck occupying most of the wall of the left internal carotid artery on the anterior (left) and left oblique (right) positions. The left posterior communicating artery runs alongside the aneurysm (arrowheads). (B) Lateral view common carotid angiography after external carotid artery–saphenous vein graft–middle cerebral artery bypass and internal carotid artery ligation shows retrograde filling of the aneurysm from the bypass graft. (C) On road map, a microcatheter passes the anastomosis site and venous valve (arrowheads) following a micro–guide wire. (D) Anteroposterior view common carotid angiography after coiling shows blood flow to the aneurysm has disappeared. The posterior communicating artery is preserved (arrowheads). World Neurosurgery 2017 98, 879.e1-879.e4DOI: (10.1016/j.wneu.2016.11.066) Copyright © 2016 Elsevier Inc. Terms and Conditions