PPT

1. DR. ANSHUL JAIN (MD,DM)
Fellowship in Neurointervention Stuttgart,
Germany
CONSULTANT NEUROINTERVENTIONAL RADIOLOGY

2. Dedicated Neurointervention cath lab.......
Advanced Evolution
• Biplane cath lab
• 3D imaging
• In built CT facility

4. Few Case examples

5. Simple and balloon assisted coiling
scenarios

6. 50 Y/M with SAH and ruptured
DACA aneurysm

8. 60 Y/M WITH ACUTE SAH
DSA shows small ACOM
aneurysm measuring 1.7X
1.4 mm

9. Use of reverse shaped microcatheter to
allow stable catheterisation of ultra small
ACOM aneurysm

10. Placement of reverse shaped
microcatheter just at neck of aneurysm

11. Coiling from neck of the aneurysm:
Placement of single 1.5 X 2mm coil

12. FINAL ANGIOGRAM
Complete occlusion of
aneurysm

13. 35 Y/F with SAH and ruptured
Pcom aneurysm with vasospasm

14. Balloon assisted coiling
Patency of Pcom branch

15. Balloon assisted coiling in right
superior hypophyseal aneurysm

16. A C
B D
BALLOON ASSISTED COILING IN LEFT
CAROTID CAVE ANEURYSM

17. 37y/F with grade 3 SAH
DSA: ruptured Rt. PCOM aneurysm with extensive
spasm in supraclinoid ICA and MCA branches

18. SEVERE SPASM
PSEUDOLOBULE
(rupture point)
3D Angiogram
PLAN: balloon assisted
coiling

19. Slow dilatation with intraraterial
nimodipine

20. Balloon assisted coiling

21. FINAL ANGIOGRAM
Tight packing of aneurysm except in region of
pseudolobule (arrow) to avoid rerupture of
fragile wall

22. Flow diverters in ruptured and
unruptured aneurysms

23. 30 Y/F with unruptured left ophthalmic
aneurysm
Treated by placement of flow diverter with
coils

24. 70 Y/F with ruptured blister A1-A2
junction aneurysm
Mini flow diverter for
distal aneurysms

25. Left V4 segment dissecting aneurysm with
involvement of PICA

26. Treated by placement of flow diverter across
the aneurysmal segment

27. Follow up DSA after 2 years
Complete arterial remodeling

29. 60 Y/F with unruptured wide neck
left MCA bifurcation aneurysm

30. Contour deployment

31. Deployed contour device

32. Stasis within the aneurysm on
delayed angiographic images

33. Stroke interventions

34. DSA: ulcerated plaque in rt. Supraclinoid
ICA
50 y/M with recurrent left sided TIA on
DAPT

35. 3D MIP: accurate estimation of stenosis

36. Wire navigation f/b balloon
plasty and stent deployment

37. FINAL ANGIOGRAM

38. 1 year follow up

39. 65 Y/M presented to ER with right
sided hemiplegia X 2 hours

40. CT ANGIOGRAM

45. Pt. improved in
cath lab with
complete
recovery of
power in left
upper and lower
limb

47. Tumor embolisation

49. Neurology, Neurointervention, Neurosurgery,
Neurocritical care,Vascular imaging,
rehabilitation
Stroke
TIAs (preventive)
SAH-aneurysms ICH
AVMs

50. Thank you