Placement of a Neuroform2 stent into the parent vessel by navigating it along the inner wall of the aneurysm sac

Introduction The Neuroform2 stent has proven to be a very helpful device in the stent-assisted coiling of wide-necked cerebral aneurysms particularly because of its high navigability. We describe the case of a 33-year-old man with a ruptured anterior cerebral artery aneurysm that was successfully embolized and a wide-necked unruptured middle cerebral artery (MCA) aneurysm that required stent-assisted coiling. Methods All attempts to catheterize the parietal branch of the MCA in order to deploy the stent were unsuccessful since various guidewires followed a circular path inside the aneurysm sac. Based on our experience on the flexibility of the Neuroform2 stent, and since the aneurysm was unruptured, we decided to follow the circular path of the wire inside the aneurysm with the stent microcatheter. Results The stent navigated easily into the parietal branch where it was correctly deployed and the aneurysm was uneventfully embolized. Conclusion This maneuver might pose the risk of aneurysm puncture in ruptured aneurysms but might prove helpful in unruptured wide-necked calcified or partially thrombosed aneurysms.