Shimon Maimon

Treatment of left P.com aneurysm.
Remodeling technique.
Complete closure of the aneurysm

חוזרים לשתף מקרים וטיפול.
Young child with ruptured Frontal AVM.
Pressure cook technique with 2 Sonic detachable 1.2×25 .
Flow coils for the plug and Squid 12 for filling the nidus and the draining vein .

The end of treatment. The nidus is completely occluded.

Ruptured, 2 month ago, big cerebellar avm. Complet occlusion one sesion with Onyx 34 Squid 12 and 2 injection of glue. Feedrs from Sca and Vermian branch of Pica.
Discharged home 3 days after treatment.

Deep arterio venous one hole fistula in a 17 years old girl from Gaza strip, that arrived with intra cranial bleeding.
Partial evacuation of hematoma were done and then the embolization performed. The fistula is supply by anterior choroidal artery distal branch. Tourtous vessel that we catheterized with Magic 1.2 fr(1/3 mm!) and arrived closed to fistula. The fiistula was oclluded with diluted glue 14%.
Occlluding the aneurysm at the fistula(the source of her bleeding), the varix in the draining vein and the artery near the lesion.
Treatment took 2 hours in a monoplain angio suit, without any complications.
The segment of the anterior choroidal that is suppling importent brain area was left open.
This is one of many patients from Gaza strip treated by me in the last 3 years.

10 year old child from other country. Treated there and coil was stack.
A disection segment with 4 aneurysms that was treated by me with long Baby leo and coils using only two m.c , Echelon 10. One for stent second for coils. After partial deployment coiling the lower aneurysm. Then moving the m.c from first aneurysm to the second one, then opning another part of the stent . coiling the second aneurysm. Fooling the Echelon from the second aneurysm. Complete deployment of the stent. Moving the m.c that was in the second aneurysm to the third in the space between the wall of vessel and stent. Coiling the third aneurysm.
Then fooling back the Echelon from the aneurysm and with the other m.c pushing the Baby to condense it.
The dissected segment is covered with the stent and the lumen of aneurysms with coils.
The child treated 4 days ago now at the hotel will fly home next week.

Wide neck P2/3 aneurysm with PCA fed by fetal P.Com.
Treatment from RT Carotid through P.Com with 2 Echelon m.c, no balloon.
Coil assist stenting, using Baby Leo 2.5 by 25.
3 coils were deployed.
Complete occlusion of the dysplastic aneurysm.
Patient was discharged 2 days later.

Embolization of a big avm with 3.5 cc of squid 12 and 3 cc onyx 34, and 0.4 cc of glue.
The AVM presented with seizure and prinidal edema in an healthy young man.
3 injection with Sonic and one (the glue) with Magic M.C.
The tiny remnant was left in purpuse, and will be occluded completely in a second sesion in two months. Done with no sequels.
Avm can be treated with low rate of complications in the hand of trained people!

Stenting and coiling, of complex bilobulated wide neck paraopthalmic aneurysm.
First coiling the small post stenting with Leo 3.5*25 then the second one. The patient has FMD and tourtous vessels.

Coiling, remodeling of a small p1 aneurysm.
S.post clipping of ruptured Carotid termination aneurysm in other hospital.
The left Carotid artery is occlluded near the clips. No need for stenting.

A spinal avm in 35 years old female. First treated 2 years ago.
Intranidal aneurysm fed by transcord artery of the ASA.
Other feeder is the PSA.
The lesion at level D11 in the latero posterior aspect of the cord.
The treatment was when she had acute paraplegia. After treatment recovered, had only leg pain.
Treatment today under general anesthesia with glue 20% oclluding the aneurysm and fistulas in nidus. Mild remnant.
Wake up ok.

A case of spinal dural a.v.fistula at right L3-4 formina with unusual enlarged radicular vein and near normal flow at anterior spinal artery. Nearly no venous delay in the ASA circulation in this 80 years olds male with severe cord edema and leg paresis. Deterioration in the last year.
Complete oclusion of the lesion with 0.6cc of Squide 12 filling the enlarged radicular vein and the fistula.
We have learned that in sdavf there is venuos delay but i have seen cases like that of today that there is no real delay.
Today morning case.

A case from last week. Mca non ruptured aneurysm. Coiling while the double lumen balloon in place but not inflated, then stenting using Bably leo 2.5×18. Another one coil to the neck area then taking out the M.C and balloon.
Patient is at home feeling well.

A case from today. A left A2 aneurysm, wide neck with left A1 feed two A2. Uguly shape.
Coiling with double lumen balloon. First remodling then 2.5×18 Baby leo through the lumen of the balloon. An unruptured aneurysm