A Case of Paraclinoid Internal Carotid Artery Aneurysm That Suffered Vessel Perforation during Pipeline Flex Placement

Objective: A case that suffered vessel perforation during flow diverter stent placement is reported. Case Presentation: The patient was a 65-year-old woman with an unruptured aneurysm 10 mm in maximum diameter at the paraclinoid portion of the left internal carotid artery. She developed disturbance of consciousness a few hours after elective flow diverter stent placement, and diffuse subarachnoid hemorrhage was noted on head CT. Although rupture of aneurysm was suspected, bleeding from the left angular artery was confirmed by emergent angiography. Trapping of the same site was carried out. Vessel perforation due to jump-up of the delivery wire was retrospectively estimated to be the cause of bleeding. Conclusion: Vessel perforation is a serious complication of intracranial endovascular treatment, and its cause and treatment are discussed with a review of the literature.