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Abstract
[1] Ruptured aneurysm has a high risk of re-bleeding with a consequent marked decreased risk of patient survival and functional independence,[5] for proximal LSA aneurysm, neurosurgery has been the mainstay of treatment, but its efficacy remains controversial. [1],[6] In this case report, we illustrated the feasibility of a tailored endovascular coiling for a patient with a subarachnoid hemorrhage due to a left proximal LSA aneurysm. Digital subtraction angiography (DSA, April 22, 2015) demonstrated a 2 mm × 3 mm fusiform aneurysm with a visualized 0.2 mm neck located at the proximal segment of the left lateral LSA [Figure 2]a. The risks and benefits of conservative medical treatment, surgical clipping, and noninvasive endovascular coiling were individually discussed with the patient and her family. A subsequent angiogram demonstrated partial embolization of aneurysm and good antegrade flow to the lateral LSA [Figure 2]b. A second 2 mm × 1.5 cm Axium Helix Platinum Coil was then placed into the aneurysm which on final check angiograms, demonstrating complete aneurysm obliteration while preserving the LSA [Figure 2]c and [Figure 2]d. Considering a complete embolization of aneurysm may cause occlusion of the ostium of the lateral LSA, the procedure was decided to be finished at this stage. Surgical challenges often faced were related to small size, deep location, and complex surrounding vasculature of these aneurysms, making intraoperative localization difficult with added postprocedure risks. [...]isolated clipping of the aneurysm neck is seldom possible and generally, sacrifice of the parent vessel is required. First because of sparse and...