Application of Optical Frequency Domain Imaging to Recanalized Unruptured Internal Carotid Artery Aneurysm Treated by Flow-Diverting Stent-Assisted Coiling.

Abstract

Here we report the application of optical frequency domain imaging (OFDI), a new optical coherence tomography device, for intravascular visualization in the treatment of a recanalized unruptured internal carotid artery aneurysm that was treated initially by stent-assisted coil embolization. OFDI revealed malapposition of the stent and lack of neointimal growth at the aneurysm neck, which was treated by deployment of a Pipeline Embolization Device to overlap the stent. An angiogram performed 1 year after the procedure revealed perfect healing of the aneurysm, and OFDI clearly demonstrated good stent apposition and total endothelialization over the aneurysm neck. OFDI/OCT appears to be a useful diagnostic tool for evaluating stent-strut apposition over the vessel wall and the grade of neointimal endothelialization across the neck of the aneurysm in aneurysmal recanalization.