scholarly journals Endovascular Therapy of a Large Vertebral Artery Aneurysm using Stent and Coils

2000 ◽  
Vol 27 (2) ◽  
pp. 162-165 ◽  
Author(s):  
Stephen P. Lownie ◽  
David M. Pelz ◽  
Allan J. Fox
Keyword(s):  
Vertebral Artery ◽  
Endovascular Therapy ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Left Vertebral Artery ◽  
Parent Artery ◽  
Combined Use ◽  
Aneurysm Occlusion ◽  
Treatment For Cerebral Aneurysms ◽  
Platinum Coils

ABSTRACT:Background:Endovascular therapy is becoming an increasingly popular treatment for cerebral aneurysms. Total angiographic occlusion of small-necked aneurysms (<4 mm) can be obtained in a high percentage of cases. The endovascular treatment of wide-necked or fusiform aneurysms remains a challenge with complete angiographic occlusion reported in <15% of cases.Case Report:We describe the combined use of a flexible coronary stent and platinum coils to treat a wide-necked aneurysm of the distal left vertebral artery, in a patient with Grade IV subarachnoid hemorrhage.Results:The procedure was technically successful as the parent artery was protected by the stent while coils were deposited in the aneurysm lumen. Although angiographic aneurysm occlusion was incomplete, the dome was packed with coils. No further hemorrhage has occurred.Conclusion:Combined endovascular stent and coil therapy is a promising technique for the treatment of wide-necked cerebral aneurysms.

Combined surgical and endovascular treatment of a giant vertebral artery aneurysm in a child

1994 ◽  
Vol 81 (2) ◽  
pp. 304-307 ◽  
Author(s):  
Mazen H. Khayata ◽  
Robert F. Spetzler ◽  
Jan J. A. Mooy ◽  
James M. Herman ◽  
Harold L. Rekate
Keyword(s):  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Mass Effect ◽  
Left Vertebral Artery ◽  
Parent Artery ◽  
Content Type ◽  
Cerebellar Artery ◽  
Coil Occlusion ◽  
Surgical Bypass

✓ The case is presented of a 5-year-old child who suffered a subarachnoid hemorrhage from a giant left vertebral artery-posterior inferior cerebellar artery (PICA) aneurysm. Initial treatment consisted of surgical occlusion of the parent vertebral artery combined with a PICA-to-PICA bypass. Because of persistent filling of the aneurysm, the left PICA was occluded at its takeoff from the aneurysm. Endovascular coil occlusion of the aneurysm and the distal left vertebral artery enabled complete elimination of the aneurysm. Follow-up magnetic resonance imaging and arteriography performed 6 months postoperatively showed persistent occlusion and elimination of the mass effect. Combined surgical bypass and endovascular occlusion of the parent artery may be a useful adjunct in the management of these aneurysms.

scholarly journals Treatment Challenges of a Primary Vertebral Artery Aneurysm Causing Recurrent Ischemic Strokes

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Davide Strambo ◽  
Luca Peruzzotti-Jametti ◽  
Aurora Semerano ◽  
Giovanna Fanelli ◽  
Franco Simionato ◽  
...  
Keyword(s):  
Blood Flow ◽  
Vertebral Artery ◽  
Color Doppler ◽  
Artery Aneurysm ◽  
Neurofibromatosis Type ◽  
Distal Portion ◽  
Embolic Stroke ◽  
Left Vertebral Artery ◽  
Stroke Recurrence ◽  
Extracranial Vertebral Artery

Background. Extracranial vertebral artery aneurysms are a rare cause of embolic stroke; surgical and endovascular therapy options are debated and long-term complication may occur. Case Report. A 53-year-old man affected by neurofibromatosis type 1 (NF1) came to our attention for recurrent vertebrobasilar embolic strokes, caused by a primary giant, partially thrombosed, fusiform aneurysm of the left extracranial vertebral artery. The aneurysm was treated by endovascular approach through deposition of Guglielmi Detachable Coils in the proximal segment of the left vertebral artery. Six years later the patient presented stroke recurrence. Cerebral angiography and Color Doppler Ultrasound well characterized the unique hemodynamic condition developed over the years responsible for the new embolic event: the aneurysm had been revascularized from its distal portion by reverse blood flow coming from the patent vertebrobasilar axis. A biphasic Doppler signal in the left vertebral artery revealed a peculiar behavior of the blood flow, alternately directed to the aneurysm and backwards to the basilar artery. Surgical ligation of the distal left vertebral artery and excision of the aneurysm were thus performed. Conclusion. This is the first described case of NF1-associated extracranial vertebral artery aneurysm presenting with recurrent embolic stroke. Complete exclusion of the aneurysm from the blood circulation is advisable to achieve full resolution of the embolic source.

scholarly journals Comparison of the In Vitro Hemodynamic Performance of New Flow Diverters for Bypass of Brain Aneurysms

2012 ◽  
Vol 134 (8) ◽  
Author(s):  
Asher L. Trager ◽  
Chander Sadasivan ◽  
Baruch B. Lieber
Keyword(s):  
Cerebral Aneurysms ◽  
Flow Diverter ◽  
Parent Artery ◽  
New Device ◽  
Design Changes ◽  
Hemodynamic Performance ◽  
Braiding Angle ◽  
Treatment For Cerebral Aneurysms

One possible treatment for cerebral aneurysms is a porous tubular structure, similar to a stent, called a flow diverter. A flow diverter can be placed across the neck of a cerebral aneurysm to induce the cessation of flow and initiate the formation of an intra-aneurysmal thrombus. This excludes the aneurysm from the parent artery and returns the flow of blood to normal. Previous flow diverting devices have been analyzed to determine optimal characteristics, such as braiding angle and wire diameter. From this information, a new optimized device was designed to achieve equivalent hemodynamic performance to the previous best device, but with better longitudinal flexibility to preserve physiological arterial configuration. The new device was tested in vitro in an elastomeric replica of the rabbit elastase induced aneurysm model and is now in the process of being tested in vivo. Particle image velocimetry was utilized to determine the velocity field in the plane of symmetry of the model under pulsatile flow conditions. Device hemodynamic performance indices such as the hydrodynamic circulation were evaluated from the velocity fields. Comparison of these indices with the previous best device and a control shows that the significant design changes of the device did not change its hemodynamic attributes (p > 0.05).

scholarly journals Combined Use of Electrolytically and Mechanically Detachable Platinum Coils for Endovascular Treatment of Cerebral Aneurysms

2004 ◽  
Vol 44 (5) ◽  
pp. 269-274 ◽  
Author(s):  
Kenji SUGIU ◽  
Atsushi KATSUMATA ◽  
Noboru KUSAKA ◽  
Wataru SASAHARA ◽  
Koji TOKUNAGA ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Aneurysms ◽  
Combined Use ◽  
Platinum Coils

scholarly journals Supraclavicular area swelling in neurofibromatosis patient

2018 ◽  
Vol 25 (5) ◽  
pp. 298-300
Author(s):  
Duk Hee Lee ◽  
Jae Hee Lee ◽  
Keon Kim ◽  
Ji Yeon Lim ◽  
Yoon Hee Choi
Keyword(s):  
Vertebral Artery ◽  
Vascular Complications ◽  
Artery Aneurysm ◽  
Neurofibromatosis 1 ◽  
Vascular Lesions ◽  
Left Vertebral Artery ◽  
Left Shoulder ◽  
Vascular Abnormality ◽  
Threatening Condition ◽  
Life Threatening

Neurofibromatosis 1 is an autosomal dominant disorder characterized by cafe-au-lait spots, cutaneous neurofibroma, and bony deformities. Vascular abnormality such as stenosis, aneurysm, or rupture associated with neurofibromatosis 1 is rare. Rupture of vertebral artery aneurysm into the thoracic cavity is extremely rare. The outcomes of patients with aneurysmal ruptures are very poor when spontaneous hemothorax occur. A 31-year-old woman presented to the emergency department with left shoulder pain and with both lower chest wall pain and left supraclavicular area swelling. The chest computed tomography scan revealed about 4-cm pseudo-aneurysm probable arising from the left vertebral artery with large hematoma at left supraclavicular area. Neurofibromatosis 1 is generally being regarded as a benign disease but has the potential for serious vascular complications. When aneurysms were ruptured, cervical hematoma, hemothorax, or hypotension was developed. It is potentially a life-threatening condition, so it must require emergent management. Emergency physicians must remember the relation of neurofibromatosis 1 and serious vascular complications and ensure rapid access to rule out vascular lesions, so as to prevent the life-threatening condition.

Antegrade recanalization of a completely embolized vertebral artery after endovascular treatment of a ruptured intracranial dissecting aneurysm

2005 ◽  
Vol 102 (1) ◽  
pp. 161-166 ◽  
Author(s):  
Motoshi Sawada ◽  
Yasuhiko Kaku ◽  
Shinichi Yoshimura ◽  
Masahiro Kawaguchi ◽  
Takashi Matsuhisa ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Cerebral Aneurysms ◽  
Systemic Circulation ◽  
Parent Artery ◽  
Content Type ◽  
Endovascular Occlusion ◽  
Aneurysmal Dilation ◽  
Dissecting Aneurysms ◽  
Fine Print

✓ Occlusion of the parent artery is a traditional method of treatment of unclippable cerebral aneurysms. Surgical or endovascular occlusion of the parent artery proximal to the aneurysm has been recommended for the treatment of dissecting aneurysms located in the vertebrobasilar circulation. Nevertheless, occlusion of the parent artery may not result in permanent exclusion of the aneurysm from the systemic circulation because, occasionally, postoperative rebleeding occurs after proximal occlusion. Alternatively, endovascular occlusion of the affected site, including the aneurysmal dilation, and parent artery, is a safe and reliable treatment for dissecting aneurysms. The authors present two rare cases of ruptured vertebral artery (VA) dissecting aneurysms that were treated by endovascular occlusion of the affected site including the aneurysm and parent artery by using Guglielmi detachable coils. In both cases the VA recanalized in an antegrade fashion during the follow-up period. Based on these unique cases, the authors suggest that a careful angiographic follow up of dissecting aneurysms is required, even in patients successfully treated with endovascular occlusion of the affected artery and aneurysm.

Successful Hybrid Management of a Left Vertebral Artery Aneurysm Secondary to Type-1 Neurofibromatosis

2014 ◽  
Vol 28 (8) ◽  
pp. 1936.e1-1936.e4 ◽  
Author(s):  
Flora Gouaillier-Vulcain ◽  
Blandine Maurel ◽  
Etienne Marchand ◽  
Robert Martinez ◽  
Jean Picquet ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Artery Aneurysm ◽  
Left Vertebral Artery ◽  
Type 1 Neurofibromatosis ◽  
Hybrid Management
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