 After informed consent was taken patient was brought to angio suite, both groin sites were prepped and draped in sterile manner.  Patient was placed under general anesthesia for entire duration of the procedure.  Groin access was obtained with a stiff micropuncture wire and a 4-French sheath was placed in the right common femoral artery and connected to a continuous heparinized saline flush.  A 4-French angled Glide catheter was then taken up into the descending thoracic aorta was double flushed and connected to a continuous heparinized saline flush.  The catheter was then taken up into the aortic arch and both common and internal carotid arteries were selectively catheterized followed by digital subtraction imaging in multiple projections.  The images showed spasm of the left internal carotid artery and the left A1, it was thought planned to infused papaverine into the ICA and the left A1.  After that the diagnostic catheter was taken up into the distal internal carotid artery.  SL-10 microcatheter was then prepped and was taken up with the support of Transcend platinum micro guide wire.  The microcatheter was then taken up into the internal carotid artery under biplane roadmapping and was taken up into the distal internal carotid artery and was pointed towards the A1.  60 mg of papaverine was then slowly infused into the internal carotid artery and the anterior cerebral artery.  Post-papaverine infusion images showed increased caliber of the internal carotid artery as well as the left A1.  The catheter was then removed from the patient, pressure was held for 10 minutes leading to hemostasis.  Patient was then transferred back to the ICU in the Children's Hospital where he was extubated without any deficits.