Anterior Cerebral Artery (A1 Segment) Aneurysm: Giant Partially Thrombosed A1 Aneurysm with Mass Effect, Treated with a Pipeline Embolization Device, Complete Resolution of the Mass Effect, and Modification of the Shape of the Implant During Long-Term Follow-Up

Abstract

A giant A1 aneurysm exerting mass effect which was displacing both A1 arteries was found in a 64-year-old male patient who had presented with headaches and diplopia. The patient was treated with a Pipeline Embolization Device with good clinical and angiographic outcomes, with the singularity that the device changed shape as the mass effect from the aneurysm diminished. Actually, management of unruptured giant intracranial aneurysms is a matter of controversy among the neurovascular community. Several endovascular strategies have been used, such as stent-assisted coiling, flow diversion, and flow diversion and coils, with varying occlusion and complication rates reported. In this chapter, we present a case which shows the feasibility of using just one flow diverter stent as a sole treatment method for giant aneurysms. The various therapeutic options for treating of giant aneurysms are the main topic of this chapter.