A 75-year-old woman presented to the hospital with coma. She had been found in her home.
Noncontrast head CT demonstrated extensive subarachnoid hemorrhage, and CTA identified a ruptured aneurysm in the anterior communicating artery. It was 9 p.m.
A neurosurgeon called me. He said, “I decide to perform coil embolization. Can you come for assistance?”
The procedure started at 11 p.m. A 6-Fr Fubuki guide catheter was advanced over the wire and navigated into the left internal carotid artery. Three-dimensional rotational angiography demonstrated a saccular aneurysm measuring 4 mm right to left, 6mm anterior-posterior, and 3 mm craniocaudal. An anterior communicating artery arose from the proximal aspect of the aneurysm wall. A 3.2-Fr Guidepost intermediate catheter was advanced to the cavernous portion of the ICA. An SL 10 microcatheter was placed into the aneurysm doom through the Guidepost. It was not difficult to place, because the A1 and the aneurysm went straight. Of course he had good skills. Three coils were placed through the SL 10. The microcatheter was removed, and subsequent angiographic views demonstrated good embolization of the aneurysm with flow stasis in the aneurysm dome and preserved flow through the anterior communicating artery.
It finished at 1 a.m. I came home and went to bed at 2 a.m.
WILLPOWER MELTDOWN SOMETIMES 