Quadri-axial Technique to Gain Access for Flow Diverter Deployment

A 64-year-old lady presented with headaches, facial pain, and left ptosis. Investigation revealed giant left internal carotid artery (ICA) aneurysm (Fig. 25.1). DSA and 3D angiography showed a wide-neck aneurysm. Inadequate flow across anterior and posterior communicating arteries was seen, and the case was planned for flow diverter stent placement (Surpass, Stryker).