scholarly journals The Usefulness of the New “Double-Catheter Technique” in the Treatment of Parent Artery Incorporated Wide-Necked Aneurysm with Guglielmi Detachable Coils

2000 ◽  
Vol 6 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Yong Sam Shin ◽  
Dong-Ik Kim ◽  
Seung Ik Lee ◽  
Jin Il Chung ◽  
Pyeong Ho Yoon ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Three Dimensional ◽  
Parent Artery ◽  
Guglielmi Detachable Coils ◽  
Viable Option ◽  
Catheter Technique ◽  
Detachable Coils ◽  
The Right ◽  
Grade Iii

We describe a technique used to treat a wide-necked aneurysm in which the neck is incorporated with the parent artery. The patient was a 54-year-old woman who had suffered a grade III subarachnoid haemorrhage. Angiogram and three-dimensional CT showed a large, wide-necked aneurysm of the basilar bifurcation area with the right posterior cerebral artery incorporated in the aneurysm sac. A microcatheter was placed in the right posterior cerebral artery (PCA). Another catheter was placed within the aneurysm lumen. When making a first frame with a GDC, we made sure that the frame of the coil did not overlap the PCA positioned microcatheter. Then, with the microcatheter positioned at the PCA, the angiogram was done. The flow pattern and dye-disappearance time were checked. Subsequent coils were introduced, but not beyond the frame of the first coil to maintain PCA flow. This new “double-catheter technique” represents a viable option for treating wide-necked aneurysms, especially when the parent artery is incorporated in a wide-necked aneurysm and the delineation of the parent artery is impossible.

scholarly journals “Mirror” Aneurysms Involving the Bilateral Distal Posterior Cerebral Artery

2004 ◽  
Vol 10 (3) ◽  
pp. 231-234 ◽  
Author(s):  
S.K. Baik ◽  
C.H. Sohn ◽  
S.K. Woo
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Clinical Manifestations ◽  
Mirror Image ◽  
Guglielmi Detachable Coils ◽  
Detachable Coils ◽  
Endovascular Approach

We report the case of patient with bilateral and symmetrical aneurysms, mirror image, of the distal posterior cerebral artery (PCA) who presented with subarachnoid haemorrhage. The aneurysms were treated by endovascular approach using Guglielmi detachable coils (GDCs). A review of the pathophysiology, clinical manifestations and management of mirror aneurysms is presented and discussed.

Bilateral Thalamic Infarcts Complicating Basilar Tip Aneurysm Coil Embolisation

1997 ◽  
Vol 3 (4) ◽  
pp. 325-328
Author(s):  
H.J. Cloft ◽  
D.F. Kallmes ◽  
G. Lanzino ◽  
M.E. Jensen ◽  
J.E. Dion
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Stenosis ◽  
Partial Occlusion ◽  
Guglielmi Detachable Coils ◽  
Coil Embolisation ◽  
Detachable Coils ◽  
Basilar Tip Aneurysm ◽  
Thalamic Infarcts

We report a case of bilateral thalamic infarcts with no apparent cause other than unilateral partial occlusion of the P1 segment of the posterior cerebral artery caused by Guglielmi detachable coils in a basilar tip aneurysm. This case demonstrates that bilateral thalamic infarctions can result from a unilateral posterior cerebral artery stenosis or occlusion, and does not necessarily imply bilateral posterior cerebral artery abnormality.

scholarly journals Treatment of a Vertebral Dissecting Aneurysm with a Balloon-Expandable Stent and Guglielmi Detachable Coils

1999 ◽  
Vol 5 (2) ◽  
pp. 171-177 ◽  
Author(s):  
T. Nakaharas ◽  
K. Kurisu ◽  
T. Yano ◽  
K. Sakoda
Keyword(s):  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Dissecting Aneurysm ◽  
Parent Artery ◽  
Guglielmi Detachable Coils ◽  
Stent Deformation ◽  
Cerebellar Artery ◽  
Detachable Coils ◽  
The Right

A 43-year-old man with dissecting vertebral artery aneurysm presented with subarachnoid haemorrhage. The vertebral angiography showed a fusiform dilatation at the right intracranial vertebral artery between the origin of posterior inferior cerebellar artery and the vertebral union. After failing conservative therapy, a balloon-expandable stent was placed at intracranial vertebral artery, in a manner such that the entire dissecting aneurysm was covered. On follow-up angiogram, we recognized regrowth of theresidual aneurysm and stent deformation. The parent artery was occluded completely with several Guglielmi detachable coils. Brainstem dysfunction or rebleeding of the aneurysm were not encountered. Recently stenting therapy was deployed for a patient with dissecting aneurysm of the extracranial carotid or vertebral artery who was not a candidate for surgical treatment. We discuss the feasibilities and limitations of stent therapy.

Republished: Successful treatment of ruptured multiple fusiform middle cerebral artery aneurysms with silk vista baby flow diverter in a 10-months-old infant

2021 ◽  
pp. neurintsurg-2021-017554.rep
Author(s):  
Giovanni Barchetti ◽  
Loris Di Clemente ◽  
Mauro Mazzetto ◽  
Mariano Zanusso ◽  
Paola Ferrarese ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Successful Treatment ◽  
Expectant Management ◽  
Flow Diverter ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Microsurgical Clipping ◽  
Parent Artery Occlusion ◽  
The Right

We report the successful treatment of multiple ruptured fusiform middle cerebral artery (MCA) aneurysms in a 10-month-old girl. This previously healthy infant presented with subarachnoid haemorrhage and was found to have multiple irregular dilatations of the superior division branch of the right MCA. Cerebral angiography was performed and confirmed the presence of multiple fusiform aneurysms of the MCA. After multidisciplinary team discussion, it was decided to treat the aneurysms with endovascular approach, using a flow-diverter. Microsurgical clipping was deemed risky because of the high likelihood of parent artery occlusion and expectant management was also considered inappropriate because of the risk of re-bleeding. Dual antiplatelet therapy was started, and a flow-diverter was successfully delivered in the superior division branch of the right MCA. The post-operative course was uneventful, MRI at 12 months did not show any sign of recurrence and at 3 years of age the patient had a normal neurological examination.

scholarly journals Microsurgical Treatment of Posterior Cerebral Artery Aneurysm (P2P Segment): Case Report and Review of the Literature

2018 ◽  
Vol 37 (04) ◽  
pp. 343-348
Author(s):  
Lucas Meguins ◽  
Antônio Spotti ◽  
Jean de Oliveira ◽  
Carlos Pereira ◽  
Ronaldo Fernandes ◽  
...  
Keyword(s):  
Case Report ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Saccular Aneurysm ◽  
Neurological Deficits ◽  
Uneventful Recovery ◽  
Cerebral Peduncle ◽  
Vast Number ◽  
The Right

Introduction Aneurysms of the posterior cerebral artery (PCA) represent ∼ 1% of all intracranial aneurysms and usually present with subarachnoid hemorrhage. Objective The aim of the present study is to describe the case of an adult man presenting a saccular aneurysm of the right PCA at the posterior half of the postcommunicating (P2P) segment, and to discuss the technical nuances of the approach and of the clipping process. Case Report An investigation of a chronic headache in a 55-year-old man found a saccular aneurysm located just posterior to the most lateral portion of the right cerebral peduncle. A digital subtraction arteriography revealed a 7.8 mm × 5.6 mm × 4.8 mm posterior-medial projecting aneurysm of the right PCA at the P2P segment. A subtemporal approach was performed with partial aspiration of the right parahippocampal gyrus for a better exposure of the vascular structures. A proximal temporary occlusion of the PCA was performed at the anterior half of the postcommunicating P2A segment. The aneurysm was clipped with two semi-curved clips. The patient presented an uneventful recovery and was discharged from the hospital on the third postoperative day without any additional neurological deficits. Conclusion Aneurysms of the PCA are an uncommon vascular disease that challenges the ability of the neurosurgeons due to their many anatomical nuances, to their vast number of perforators, and to the risk of bleeding. However, the operative management of aneurysms of the PCA is technically feasible, safe and effective when performed respecting microsurgical principles.

scholarly journals Late Thromboembolic Events after Treatment of Intracranial Aneurysms with Guglielmi Detachable Coils

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 356-357
Author(s):  
Colin P Derdeyn ◽  
Christopher J Moran ◽  
DeWitte T Cross ◽  
Michael R Chicoine ◽  
Ralph G Dacey
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Artery Aneurysm ◽  
Additional Patient ◽  
Superior Cerebellar Artery ◽  
Parent Artery ◽  
Imaging Data ◽  
Guglielmi Detachable Coils ◽  
Kaplan Meier ◽  
Detachable Coils

P98 Purpose: Thrombo-embolic complications associated with the endovascular treatment of intracranial aneurysms with Guglielmi Detachable Coils (GDC) generally occur at the time of the procedure or soon after. The purpose of this report is to determine the frequency of late thrombo-embolic events after GDC. Methods: The records of 189 patients who underwent GDC repair of one or more intracranial aneurysms at our institution were reviewed. The occurence of an ischemic event referrable to a coiled aneurysm was determined by clinical, angiographic, and imaging data. Events occuring within 2 days of the endovascular procedure were considered peri-procedural. Kaplan-Meier analysis of ischemic events over time was performed. Results: Two patients suffered documented thrombo-embolic events. One patient presented 5 weeks after coiling with a transient ischemic attack. Angiography demonstrated thrombus on the surface of the coils at the neck of a large ophthalmic artery aneurysm. The second patient presented with a posterior circulation stroke 4 weeks after coiling of a large superior cerebellar artery aneurysm. Angiography showed no significant proximal disease, with thrombus beginning at the neck of the treated aneurysm and extending out both P1 segments. No intra-procedural problems during the initial coiling had occured with either patient. There was no evidence for protrusion of coils into the parent artery in either patient. Both patients had been receiving daily aspirin (325 mg). One additional patient reporting symptoms suggesting possible ischemics event was evaluated and diagnosed as having atypical migraines. The frequency of a clinical thromboembolic event during the first year after coiling (excluding procedural complications) was 1.1%. Conclusions: Thrombo-embolic events may occur as late as 5 weeks after endovascular treatment of aneurysms with GDC.

Role of parent artery sacrifice in the treatment of posterior cerebral artery aneurysms

2020 ◽  
Vol 68 (2) ◽  
pp. 325
Author(s):  
RimalH Dossani ◽  
David Smolar ◽  
Muhammad Waqas
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Parent Artery

scholarly journals Recurrent transient heading disorientation heralding acute posterior cerebral artery (PCA) infarction

2019 ◽  
Vol 1 (1) ◽  
pp. e000009
Author(s):  
Yong Chuan Chee ◽  
Beng Hooi Ong
Keyword(s):  
Case Report ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Transient Ischaemic Attack ◽  
Posterior Cerebral Artery ◽  
Underlying Mechanism ◽  
Unusual Presentation ◽  
Topographical Disorientation ◽  
Ischaemic Attack ◽  
The Right

ObjectiveHeading disorientation is a type of pure topographical disorientation. Reported cases have been very few and its underlying mechanism remains unclear. We report an unusual presentation of a 60-year-old man with recurrent transient heading disorientation heralding an acute posterior cerebral artery infarction.DesignCase report.ConclusionAcquired injury to the right retro-splenial region can result in a specific variant of topographical disorientation known as heading disorientation that may present as an atypical transient ischaemic attack-like symptom heralding acute cerebral infarction.

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