Evaluation of Neointimal Coverage After Placement of a Flow Diverter Using Angioscopy

PIPELINE Flex (Medtronic, Minneapolis, MN) embolization flow diverter device was implanted in a patient in their 60s to treat an aneurysm in the left cavernous internal carotid artery (Figure [A]).Six months after the operation, internal carotid artery angiography showed the complete occlusion of the aneurysm (Figure [B and C]).Cone-beam computed tomography with 20% diluted contrast showed only partial neointimal coverage (Figure [D]).A VISIBLE angioscope (Fiber Tech, Tokyo, Japan) was used to observe the neointimal coverage.