It was reported that treatment was attempted on an anterior communicating artery aneurysm (acom) which had an acute takeoff angle from the parent artery.After multiple attempts, the microcatheter finally gained access to the aneurysm from the right internal carotid artery (ica); however, the web device was not opening adequately, despite several deployment attempts.The microcatheter and web device were removed.A new via 21 microcatheter was successful at obtaining access to the aneurysm from the left ica.Deployment of the same web device was attempted, but efforts were unsuccessful due to difficult anatomy.During partial deployment of the web, a new roadmap image was obtained, which demonstrated an aneurysm rupture with contrast extravasation.The web device was removed and the aneurysm was partially coiled through the via microcatheter, which was effective at controlling the bleeding; however, changes in the patient's vital signs were indicative of a subarachnoid hemorrhage.The aneurysm treatment was stopped at this point so that an evd could be placed.The patient was stable at the end of the procedure.The patient is reported to have recovered and the aneurysm was retreated with another endovascular procedure.
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