Hello!

My name is George and I am from Greece. The topic of this thread is Fusiform aneurysm and probable Endovascular Treatment. It's well known that fusiform aneurysms are rather rare and quite difficut to decide the appropriate treatment method
So, if anybody wishes to contribute to the conversation it would have been so helpful.
As a starting point, you can find below the diagnosis script from my angiography test in Switzerland last December:

Diagnosis:Giant (30mm) M1-unruptured fusiform aneurysm on the left side.
Therapy: Complete selective cerebral angiography and balloon-occlusion test of the left M1-segment in a case with a giant M1-aneurysm on the left side (under general anaesthesia).
Personal History:Intermittent head and neck pain since summer 2008
Car accident in 1995
Obstructive Sleep Apnea Syndrome
Medication:None
Allergies:No known drug allergies
Physical Examination:Right pupil discretely larger than the left one. Pupils reactive to light. Other cranial nerves, motor and sensory exam, reflexes and coordination unremarkable.
Therapy:As a patint, I was found by imaging to have a mostly asymptomatic but giant non-thrombosed aneurysm of the left M1-segment. There is no associated perianeurysmal edema and no evidence of abnormal wall enhancement.
Based on these findings a selective angiographic investigation including functional balloon-occlusion test of the M1-segment on left side is planned.
Selective cerebral angiography confirms the presence of a giant, non-thrombosed, fusiform aneurysm arising from the left middle and distal M1-segment, distal to the origin of the left lenticulo-striate artery and the anterior temporal artery. It incorporates the MCA-bifurcation.
There is decreased anterograde flow in the M2-M3 territories on the left side and already visible activated retrograde lepto-meningeal collaterals from A5 and P5. However, these collaterals do not retrogradly reach the MCA-bifurcation area, indicating that they are not fully developed.
Subsequently a micro-balloon is passed through M1-segment and through the aneurysm and positioned at the exit side of the aneurysm, where it is inflated. During occlusion of the proximal M2-segment cerebral angiography shows more prominent visualization of the retrograde lepto-meningeal collaterals, described above now reaching the area of the MCA-bifurcation but nevertheless, being still insufficient for permanent occlusion of the M2-segment.
The test is repeated by occluding the M1-segment proximal to the origin of the aneurysm giving similar results. Selective external carotid angiography shows a normal calibre and normal configuration of the left superficial temporal artery.
This investigation revealed and confirmed the presence of a non-thrombosed giant M1-aneurysm on the left side with ongoing retrograde lepto-meningeal collateral development.
The medical team proposed a repeat balloon-occlusion test in approx. 6 months in order to evaluate the progression of the retrograde lepto-meningeal collateral development and decide about the endovascular treatment.

Hope that the above picture isn't so disappointing

Waiting for your fusiform data experience
Best regards
George