Middle Cerebral Artery Aneurysm Trial (MCAAT): A randomized care trial comparing surgical and endovascular management of MCA aneurysm patients

2021 ◽  
Author(s):  
Tim E. Darsaut ◽  
Michael B. Keough ◽  
William Boisseau ◽  
J. Max Findlay ◽  
Michel W. Bojanowski ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Aneurysm ◽  
Endovascular Management ◽  
Middle Cerebral Artery Aneurysm ◽  
Mca Aneurysm ◽  
Cerebral Artery Aneurysm

scholarly journals Middle cerebral artery aneurysm surgery after stent misplacement: A case report

2015 ◽  
Vol 22 (1) ◽  
pp. 49-52 ◽  
Author(s):  
Abdul Rahman Al-Schameri ◽  
Manuel Lunzer ◽  
Cornelia Daller ◽  
Michael Kral ◽  
Monika Killer
Keyword(s):  
Case Report ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Aneurysm ◽  
Aneurysm Surgery ◽  
Middle Cerebral Artery Aneurysm ◽  
Surgical Clipping ◽  
Increased Risk ◽  
Mca Aneurysm ◽  
Cerebral Artery Aneurysm

Stent misplacement during endovascular treatment of middle cerebral artery (MCA) aneurysms can cause challenges and be problematic, if clipping becomes necessary. This article reports on a 56-year-old woman with an unruptured, multi-lobulated MCA aneurysm, whom primarily refused surgery; therefore, she was scheduled for stent-assisted coiling. After successful deployment of the stent, it unfortunately then became snagged by the microcatheter and was pulled backwards. The subsequent surgical procedure (i.e. clipping of the MCA aneurysm) was challenging, due to the position of the dislodged stent. Such as misplacement of the stent is rarely documented: It resulted in the difficult handling of a MCA aneurysm. Aneurysms of the MCA should primarily be considered for surgical clipping. In conclusion, an increased risk for eventual surgery should be considered, in cases where endovascular treatments with stents are performed.

Rupture of previously documented small asymptomatic saccular intracranial aneurysms

1992 ◽  
Vol 76 (6) ◽  
pp. 1019-1024 ◽  
Author(s):  
Wouter I. Schievink ◽  
David G. Piepgras ◽  
Fremont P. Wirth
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Intracranial Aneurysms ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Careful Consideration ◽  
Middle Cerebral Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Cerebellar Artery ◽  
Cerebral Artery Aneurysm

✓ In a recent study from the Mayo Clinic on the natural history of intact saccular intracranial aneurysms, none of the aneurysms smaller than 10 mm in diameter ruptured. It was concluded that these aneurysms carry a negligible risk for future hemorrhage and that surgery for their repair could not be recommended. These findings and recommendations have been the subject of much controversy. The authors report three patients with previously documented asymptomatic intact saccular intracranial aneurysms smaller than 5 mm in diameter that subsequently ruptured. In Case 1, a 70-year-old man bled from a 4-mm middle cerebral artery aneurysm that had been discovered incidentally 2½ years previously during evaluation of cerebral ischemic symptoms. A 10-mm internal carotid artery aneurysm and a contralateral 4-mm middle cerebral artery aneurysm had not ruptured. Case 2 was that of a 66-year-old woman who bled from a 4-mm pericallosal aneurysm that had been present 9½ years previously when she suffered subarachnoid hemorrhage (SAH) from a 7 × 9-mm posterior inferior cerebellar artery aneurysm. Although the pericallosal aneurysm had not enlarged in the intervening years, a daughter aneurysm had developed. The third patient was a 45-year-old woman who bled from a 4- to 5-mm posterior inferior cerebellar artery aneurysm that had measured approximately 2 mm on an angiogram obtained 4 years previously; at that time she had suffered SAH due to rupture of a 5 × 12-mm posterior communicating artery aneurysm. These cases show that small asymptomatic intact saccular intracranial aneurysms are not innocuous and that careful consideration must be given to their surgical repair and long-term follow-up study.

Rupture of a Previously Unruptured Giant Middle Cerebral Artery Aneurysm after Extracranial-Intracranial Bypass Surgery

Neurosurgery ◽  
1982 ◽  
Vol 10 (5) ◽  
pp. 600-603 ◽  
Author(s):  
R. Michael Scott ◽  
Hsiu-Chih Liu ◽  
Robert Yuan ◽  
Lester Adelman
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Bypass Surgery ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Aneurysm Surgery ◽  
Middle Cerebral Artery Aneurysm ◽  
Fatal Hemorrhage ◽  
Cerebral Artery Aneurysm ◽  
Direct Attack

Abstract The fatal rupture of a previously unruptured giant middle cerebral artery aneurysm occurred 13 days after an extracranial-intracranial bypass had been carried out, before definitive aneurysm surgery. Alterations in blood flow adjacent to the aneurysm after the bypass may have led to the fatal hemorrhage. After a preliminary extracranial-intracranial bypass procedure, there should be no undue delay in the direct attack on a giant aneurysm, regardless of its mode of presentation.

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