Giant, partially thrombosed fusiform aneurysm of the right ICA treated by a construct of 2 PEDs. The specimen was removed 13 months after treatment. Giant,

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Presentation transcript:

Giant, partially thrombosed fusiform aneurysm of the right ICA treated by a construct of 2 PEDs. The specimen was removed 13 months after treatment. Giant, partially thrombosed fusiform aneurysm of the right ICA treated by a construct of 2 PEDs. The specimen was removed 13 months after treatment. A, DSA before treatment showing the circulating portion of the partially thrombosed GFA involving the supraclinoid ICA on the right. B, DSA 1 year after treatment showing angiographic reconstruction of the entire length of the fusiform aneurysm. C. Thin fibrin layer removed from the luminal surface of the PED construct by H&E staining. The arrows in C and D point to the impressions of the flow-diverter struts on the outer surface of the fibrin layer. D, h-Caldesmon staining fails to show smooth muscle cells inside this layer. E, CD34 fails to show endothelial coverage on the luminal surface (arrows) of the layer. F, Histologic section showing a thick aneurysm wall with low cell attenuation (star) and fresh thrombus underneath the wall (double star) by H&E staining. G, h-Caldesmon staining fails to show any smooth muscle cells within the wall (star) or invasion into the clot (double star). H, Picrosirius staining reveals subintimal connective tissue within the thick aneurysm wall (star) but no invasion into the thrombus (double star). I. Szikora et al. AJNR Am J Neuroradiol 2015;36:1716-1720 ©2015 by American Society of Neuroradiology