1. Cerebral aneurysm-single center experience

2. Historical review
1974 Serbrenenko first reported cases of latex balloon embolization.?
1984 Ramadanov et al. present Russian experience in endovascular procedures?
1992 Gugliamini detachable coil * (GDC) registered with the FDA-Food and drug administration in 1995?
1997 Team G. Sea presents the experience in balloon-remodeling technique for endovascular treatment of with-neck aneurysm?
Higashida et al. in 1997 presented stent remodeling technique with coronary stents?
Dr. P. Nelson presents self expandable nitinol stents developed by Boston Saentifik Neuroform stent supported techniques?
2006 EV3 to develop Self expandable stent for treatment of aneurysms with a flow-divert feature.

3. Indications for aneurysm coiling
Posterior circulation aneurysms
Multiple aneurysms
Paraclinoid aneurysms
Aneurysms with severe vasospasm
Patient I extremes of age
Giant/serpentine, fusiform, dissecting, mycotic and pseudoaneurysms
Blood-blister like aneurysms (Ogawa aneurysms)
Aneurysms with brain AVM
ISAT supports offering coiling when there is high likelihood of success.

4. Limitations of endovascular treatment
Tortuosity of neck vessels (Stability of arterial access is the primary step for endovascular treatment)
Renal failure *
Non-availabilitiy of modern DSA facility
High cost of material
Aneurysms with large parenchymal clot may require surgical evacuation end clipping done in the same sitting.

5. Еxisting techniques
Coil embolization - platinum embolization coils - bio active coils
2. Balloon-remodeling technique

6. 3. Stent remodeling technique
4. Self stent technique / Flow diverter

7. Materilail and methods
For the period from March 2010 to November 2012 were at the clinic 47 embolized aneurysms of which :
-16 in SVD and 31 respectively in the VSA Com. Ant Com.post A. Cerebri med ICA in the cavernous and optico-carotid region. When performing endovascular procedures were used 8 Flow divert device, one stent Soliter and stakes of the Helix Axium and EV3.

8. Clinical case 1: 26 years-old woman with intractable headache
Clinical case 1: years-old woman with intractable headache . Has made ​​CT angiography

10. Stenting of aneurysm-1

11. stenting fo aneurysm
Stenting of aneurysm-2

12. Stenting of aneurysm-3

13. Control angiography after stent implantation

14. Control angiography after one year

15. Clinical case 2. Patients 38 years –old , with subarachnoid hemorrhage data , prior to 25 days without lateralized neurological symptoms.

19. MRT control after 11 months

21. Clinical case 3. Man of 57 years-old , with unruptured aneurysm of a
Clinical case 3 . Man of 57 years-old , with unruptured aneurysm of a. bazilaris

22. Coiling
After then Stenting

23. Clinical case 3 . Man of 55 years-old with unruptured aneurysm of MCA

28. Control angiography after coiling of aneurysm.

29. MRT control after 6 months

30. Control angiography after 6 months. )

31. Control angiography after 6 months.

32. Results: The average age of the patients was 52.2 years(24-70).
The average hospital staying was 5.9 days (3-15).?
Complications: One patient on the third day after the procedure was a symptoms of ischemic stroke in RMCA. Aneurysm was treated as a a.com.ant. Through thrombolytic and vasoprotecticve therapy the patient was discharged with improvement.
All patients were discharged without additional neurological symptoms.
Track: Patients were followed up with a CT angio and MRI with contrast 3,6,9 months after the procedure and control angiography after 1year
If a patient to establish a new growth of the aneurysm a. cerebri med.
CONCLUSION Metod relatively safe with low morbidity and mortality rate .
Short-term hospitalization
Endovascular treatment should be first choice for the treatment of aneurysms in the SVD and optico-carotid segment ICA.