Fig. 5

Patient with bilateral, symmetric internal carotid aneurysms who was treated with a Surpass (cobalt chromium) device on the right and a Silk (nitinol) device on the left. The aneurysm on the left was also coiled, so the patient met the exclusion criteria and was not included in the final analysis. However, the images are provided, for demonstration purposes only, to display the striking difference in signal loss, which is more significant on the right side despite the presence of coils on the contralateral side. The native images show both devices on RAO view (a and d). The native b image of the right carotid angiogram and the left carotid angiogram E along with the subtracted views c and f respectively show no evidence of a residual aneurysm or parent artery stenosis on the right or left on RAO view. The native images show both devices on LAO view g and j. Likewise, both the native views of the right h and left k carotid angiograms and also the corresponding subtracted views I and l do not reveal an aneurysm or stenosis. The MPR reconstructions of noncontrast MRA study (m–o). The left sided carotid siphon is somewhat delineated on the MIP image obtaioned without postprocessing Whereas the right siphon is not visualized (m). After manual removal of the posterior circulation from the MIP dataset, the LAO n and the RAO o projections that correspond to the DSA images demonstrate a substantial loss of signal on the right as compared to the left despite the presence of coils on the left which are known to cause further artifacts