Direct percutaneous puncture of a cervical internal carotid artery aneurysm for coil placement after previous incomplete stent-assisted endovascular treatment.

Direct percutaneous puncture for coil placement has been described for visceral aneurysms, but the procedure has not been previously reported for aneurysms of the head and neck. We report a case in which stent-assisted endovascular treatment was successfully combined with direct puncture for additional coil placement to treat a symptomatic giant aneurysm of the cervical internal carotid artery.