Hao Zhu, Yang Wang, Yunpei Liu, Yingang Wu, Ge Gao
{"title":"X-configuration Pipeline Flex embolization device for complex anterior communicating artery aneurysm: illustrative case.","authors":"Hao Zhu, Yang Wang, Yunpei Liu, Yingang Wu, Ge Gao","doi":"10.3171/CASE25415","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Complex anterior communicating artery (ACoA) aneurysms involving bilateral anterior cerebral arteries present significant challenges for stent-assisted coiling (SAC). Flow diversion (FD) devices offer a viable alternative for managing such anatomically complex lesions.</p><p><strong>Observations: </strong>An adult patient with a complex 11.21 × 14.28-mm ACoA aneurysm involving bilateral A1-A2 segments underwent FD using two Pipeline Flex embolization devices) deployed in an X-configuration. Conventional clipping or SAC was deemed unsuitable due to anatomical complexity. Postprocedural imaging demonstrated optimal device positioning with contrast retention within the aneurysm sac.</p><p><strong>Lessons: </strong>Follow-up at 3-month and 18-month intervals confirmed complete occlusion with favorable vascular remodeling and without complications, demonstrating the safety and efficacy of this strategy for anatomically challenging aneurysms. https://thejns.org/doi/10.3171/CASE25415.</p>","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 13","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477892/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of neurosurgery. Case lessons","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3171/CASE25415","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Complex anterior communicating artery (ACoA) aneurysms involving bilateral anterior cerebral arteries present significant challenges for stent-assisted coiling (SAC). Flow diversion (FD) devices offer a viable alternative for managing such anatomically complex lesions.
Observations: An adult patient with a complex 11.21 × 14.28-mm ACoA aneurysm involving bilateral A1-A2 segments underwent FD using two Pipeline Flex embolization devices) deployed in an X-configuration. Conventional clipping or SAC was deemed unsuitable due to anatomical complexity. Postprocedural imaging demonstrated optimal device positioning with contrast retention within the aneurysm sac.
Lessons: Follow-up at 3-month and 18-month intervals confirmed complete occlusion with favorable vascular remodeling and without complications, demonstrating the safety and efficacy of this strategy for anatomically challenging aneurysms. https://thejns.org/doi/10.3171/CASE25415.