Dr. Leonardo Rangel Castilla

29/11/2025

PIPELINE EMBOLIZATION DEVICE FOR TREATMENT OF EXTRACRANIAL INTERNAL CAROTID ARTERY PSEUDOANEURYAMS

BACKGROUND: There is a paucity of literature regarding treatment options for extracranial aneurysms of internal carotid artery pseudoaneurysms. To date Pipeline stent use for the treatment of extractanial ICA aneurysms of the ICA has only been reported from single center case series.

OBJECTIVE:ToevaluatethesafetyandefficacyofPEDforthetreatmentofextracranialICA
pseudoaneurysms.

METHODS: This is a multicenter retrospective study involving 6 high-volume tertiary
academic institutions in the United States. We analyzed patients with extracranial ICA
pseudoaneurysms treated with PED between January 1, 2011, and January 1, 2019. Clinical
assessment was performed pre- and postintervention using the modified Rankin Scale (mRS) and National Institution of Health Stroke Scale (NIHSS) at a minimum of 4-mo
follow-up.

RESULTS: A total of 28 pseudoaneurysms with a mean diameter of 17.7 mm (range:
4.1-52.5mm) were treated with PED in 24 patients at 6 participating centers. At a mean of 21-mo(range4-66mo) follow-up, complete occlusion was achieved in 89% (n= 25/28), with near-complete occlusion(>90%occlusion)in the reminder.
CONCLUSION: The treatment of extracranial ICA pseudoaneurysms with PED is safe and
effective in selected patients.

28/11/2025

BRAIN ANEURYSM 🧠
SIMPLE COILING

Patients with Large aneurysm have a 50% death rate‼️, if survive, 50% will have a neurologically disability. Here we present a 59 years/old lady with multiple brain aneurysms.. We treated the largest with the highest risk of rupture with a very simple endovascular technique, simple coiling. The aneurysm is a 7mm posterior communicating artery aneurysm. The narrow neck of the aneurysm favored a good simple coiling embolization.

With this technology, we can treat deadly brain aneurysms. It only takes a groin puncture, one hour procedure and 24 hour hospitalization. Procedure was done with patient awake.

1. 3D video Posterior communicating artery Aneurysm
2. 3D image of same Aneurysm
3. Coiling
4. Coiling
5. Coiling
6. Final result
7. Aneurysm treated and posterior communicating artery patent

Hemorrhage lifethreatening subarachnoidhemorrhage aneurysm brainaneurysm ANGIOGRAPHY thirdventriculostomy endovascular coil ABNS americanboardcertifiedneurosurgeon mexicanboardcertifiedneurosurgeon usatrained teamwork usa mexico

27/11/2025

26/11/2025

3 ANEURISMAS EN PACIENTE DE 60 AÑOS
Dr. Leonardo Rangel Castilla
Neurosurgeon | Cerebrovascular | Endovascular
🏥 Hospital Lomas de San Luis, Consultorio 108
📍San Luis Potosí S.L.P.
📲 444 323 3101

14/11/2025

LARGE POSTERIOR COMMUNICATING ARTERY and OPHTHALMIC ANEURYSMS

BLACK FRIDAY SALE ‼️‼️

2 x 1 Aneurysm treatment

A 65 years old female was found to have a large posterior communicating artery aneurysm on MRI after work-up for headache and visual disturbances, we offered endovascular Embolization with flow diverter stent.
During initial angiography we found a second aneurysm around the same region.

1 hr surgery, all surgery through a 2mm groin puncture

Awake patient

Outpatient procedure (less than 24 hrs within the hospital).

1. 3D video showing large posterior communicating artery aneurysm
2. 3D image
3. Angiography lateral view
4. Microcatheter and microwire up
5. Stent flow diverter (Surpass Evolve)
6. Deployment stent
7. Deployment stent
8. Flow stasis within aneurysm AP view

12/11/2025

HISPANIC and AFRICAN-AMERICAN PATIENTS with STROKE have worse outcome than white patients.

In 2019, in the STROKE journal , we published an analysis demonstrating racial disparities in patients with acute ischemic stroke. Unfortunately, we found that Hispanic and African-American patients do not benefit nor have access to ideal treatment with mechanical thrombectomy or endovascular treatment, this is mostly related to financial and economical issues, not because the ethnicity. Similarly, In Latin America, most private hospitals offer this adequate isquemic stroke treatment, whereas public hospitals do not. This is far from being fixed due to lack of government support.

12/11/2025

11/11/2025

Estrés, Eustrés y Distrés.

Dr. Leonardo Rangel Castilla
Neurosurgeon | Cerebrovascular | Endovascular
🏥 Hospital Lomas de San Luis, Consultorio 108
📍San Luis Potosí S.L.P.
📲 444 323 3101

05/11/2025

OPHTHALMIC ARTERY ANEURYSM

1 hr surgery through a 2mm groin puncture
Outpatient procedure (less than 24 hrs within the hospital).

50 yo female with strong history of familial ruptured cerebral aneurysms and visual disturbances on left eye. She was found to an ophthalmic artery aneurysms. The aneurysm was treated endovascularly with stent flow diversion.

1. 3D image showing ophthalmic artery aneurysm
2. Angiography lateral view showing artery and aneurysm measurements
3. Microcatheter and microwire up
4. Stent flow diverter (Surpass Evolve)
5. Deployment stent
6. Deployment stent
7. Deployment stent. 8. Flow stasis within aneurysm lateral view



www.drleonardorangel.com

🌐 San Luis Potosí, México
📧 lrcastilla@hotmail.com
☎️ Office 4444 23 31 01

05/11/2025

Colocación de Diversor de Flujo para Aneurisma Cerebral

Dr. Leonardo Rangel Castilla
Neurosurgeon | Cerebrovascular | Endovascular
🏥 Hospital Lomas de San Luis, Consultorio 108
📍San Luis Potosí S.L.P.
📲 444 323 3101

29/10/2025

🧠🌍 Hoy es el Día Mundial del Infarto Cerebral.
Recordemos que cada minuto cuenta: reconocer los signos de alarma y actuar rápido puede salvar una vida.
Prevenir, detectar y atender a tiempo es la clave. ❤️‍🩹

28/10/2025

Tumor Hipofisiario - resección transesfenoidal

Dr. Leonardo Rangel Castilla
Neurosurgeon | Cerebrovascular | Endovascular
🏥 Hospital Lomas de San Luis, Consultorio 108
📍San Luis Potosí S.L.P.
📲 444 323 3101