Subarachnoid hemorrhage due to a ruptured cerebral aneurysm is a disastrous event accounting for approximately 5%-15% of all stroke cases and has a high mortality rate. One of the major goals in the management of these patients is to prevent rebleeding by securing the aneurysm either surgically or by endovascular means. Endovascular treatment is considered the first line of treatment for intracranial aneurysms; however, wide-neck aneurysms (WNAs) are specifically difficult to treat by endovascular means due to the difficulty in achieving a stable coil mass inside the aneurysm sac. To overcome this problem, assisted endovascular treatment techniques and devices have evolved over the years. Amongst these, stent-assisted coiling (SAC) techniques provide a scaffold for coil embolization. The concept of the stent-assisted technique inspired creative pioneers to invent new tools like the PulseRider (Pulsar Vascular, Inc. CA, USA) and the pCONUS (Phenox GmbH, Germany), which are a great help in managing wide-neck and bifurcation aneurysms. The concept of stent within stents and its related hemodynamic effect has led to the novel development of flow diverters for reconstructing the arterial wall and correcting the hemodynamic disturbances. In this article, we review the stents and stent-like devices currently in practice for the endovascular management of wide-neck and branch intracranial aneurysms.

Vertebral artery (VA) injury during catheterization is quite rare given its anatomical position, but can be catastrophic when it is not discovered early on and managed accordingly. A multidisciplinary approach to the management of such injury has to weigh-in the benefits and risks of open surgery versus endovascular intervention. This can be done after thorough assessment of the patient’s condition and accessibility of the injured vessel. We report a case of a 90-year-old female admitted as a case of pneumonia associated with decreased level of consciousness. She acquired an iatrogenic injury due to insertion of central venous catheter (CVC) into her dominant right VA as confirmed via CT angiography (CTA). This case report aims to highlight the role of endovascular intervention in the acute management of VA injury in a critically ill patient.

Solitary plasmacytoma is an uncommon tumor. We present a case in an unusually young patient demonstrating the mini brain sign that has been published in a couple of reports as a diagnostic radiological pattern produced by plasmacytoma. Identification of “mini brain appearance” on imaging can direct the radiologist and clinicians to the diagnosis of plasmacytoma and obviate the necessity of pre-operative biopsy.

the procedure and on 6 weeks follow up CT scan. There were two minor complications (n = 2, 13%). Conclusions: Fluoroscopy guided percutaneous hydrodissection is a safe and effective technique prior to radiofrequency ablation of hepatic malignancies abutting the liver capsule.