Related Experiment Video
Updated: Jan 16, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
X-configuration Pipeline Flex embolization device for complex anterior communicating artery aneurysm: illustrative
Hao Zhu1, Yang Wang1, Yunpei Liu1
1Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China.
Background:
Complex anterior communicating artery (ACoA) aneurysms involving bilateral anterior cerebral arteries present significant challenges for stent-assisted coiling (SAC). Flow diversion (FD) devices offer a viable alternative for managing such anatomically complex lesions.
Observations:
An adult patient with a complex 11.21 × 14.28-mm ACoA aneurysm involving bilateral A1-A2 segments underwent FD using two Pipeline Flex embolization devices) deployed in an X-configuration. Conventional clipping or SAC was deemed unsuitable due to anatomical complexity. Postprocedural imaging demonstrated optimal device positioning with contrast retention within the aneurysm sac.
Lessons:
Follow-up at 3-month and 18-month intervals confirmed complete occlusion with favorable vascular remodeling and without complications, demonstrating the safety and efficacy of this strategy for anatomically challenging aneurysms. https://thejns.org/doi/10.3171/CASE25415.
