scholarly journals Partial thrombosis of an anterior communicating artery aneurysm prior to endovascular coiling, with intra-procedural distal thrombus embolization

2017 ◽  
Vol 23 (6) ◽  
pp. 589-593 ◽  
Author(s):  
Will Guest ◽  
Dipanka Sarma ◽  
Thomas Marotta
Keyword(s):  
Rare Event ◽  
Artery Aneurysm ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Time Interval ◽  
Thromboembolic Stroke ◽  
Anterior Communicating Artery Aneurysm ◽  
The Right ◽  
Partial Thrombosis ◽  
Intracranial Circulation

Thromboembolic stroke from migration of thrombus formed in non-giant intracranial aneurysms is a recognized but rare event. We describe a case of partial thrombosis of a 7 mm anterior communicating artery aneurysm, which embolized to the right callosomarginal artery in the brief time interval between two sequential diagnostic angiograms performed as part of elective endovascular coiling, and before any instrumentation had been advanced into the intracranial circulation. To our knowledge, this is the first reported case of aneurysmal thrombus embolization observed angiographically in near real time.

scholarly journals Coaxial Access for Microcatheter Stabilization During Aneurysm Coiling: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Miri Kim ◽  
Rachyl Shanker ◽  
Anthony Kam ◽  
Matthew Reynolds ◽  
Joseph C Serrone
Keyword(s):  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Distal Catheter ◽  
Anterior Communicating Artery Aneurysm ◽  
Class 1 ◽  
Previously Treated ◽  
Aneurysm Occlusion ◽  
Intracranial Circulation ◽  
Aneurysm Coiling

Abstract Coaxial support is a fundamental technique utilized by neurointerventionalists to optimize distal catheter control within the intracranial circulation. Here we present a 41-yr-old woman with a previously coiled ruptured anterior communicating artery aneurysm with progressive recurrence harboring tortuous internal carotid anatomy to demonstrate the utility of coaxial support. Raymond-Roy classification of initial aneurysm coiling of class 1 resulted as class 3b over the 21 mo from initial treatment.1 The patient consented to stent-assisted coiling for retreatment of this aneurysm. Coaxial support was advanced as distally as possible in the proximal vasculature to improve catheter control, reducing dead space within which the microcatheter could move, decreasing angulations within proximal vasculature, limiting the movement of the native vessels, and providing a surface of lower friction than the endothelium. As the risk of recurrent subarachnoid hemorrhage in previously treated coiled aneurysms approaches 3%, retreatment occurs in 16.4% within 6 yr2 and in 17.4% of patients within 10 yr.3 Rerupture is slightly higher in patients who underwent coiling vs clipping, with the rerupture risk inversely proportional to the degree of aneurysm occlusion,4 further substantiating that coaxial support provides technical advantage in selected patients where additional microcatheter control is necessary for optimal occlusion. Pitfalls of this technique include vasospasm and vascular injury, which can be ameliorated by pretreatment of the circulation with vasodilators to prevent catheter-induced vasospasm. This case and model demonstration illustrates the technique of coaxial access in the stent-assisted coiling of a recurrent anterior communicating artery aneurysm and identification and management of catheter-induced vasospasm.

scholarly journals Terson's Syndrome

2010 ◽  
Vol 37 (6) ◽  
pp. 861-862 ◽  
Author(s):  
Francois Paquette ◽  
Tim E. Darsaut ◽  
Mikael Sebag ◽  
Alain Weill
Keyword(s):  
Artery Aneurysm ◽  
Retinal Hemorrhage ◽  
Right Visual Field ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Neurological Exam ◽  
Terson’S Syndrome ◽  
Terson's Syndrome ◽  
The Right ◽  
Visual Complaints

A 51-year-old male was admitted following subarachnoid hemorrhage (SAH) (Figure 1). His Glasgow coma score was 15. Other than headache and a defect in his right visual field, his neurological exam was normal. Cerebral angiography demonstrated a 3 mm anterior communicating artery aneurysm which was successfully excluded with endovascular coiling. Due to persistent visual complaints, an ophthalmology consult was obtained, which revealed a scotoma of the right eye. Fundoscopy demonstrated a large subhyaloid hemorrhage of the right eye (Figure 2), and a small retinal hemorrhage with papilledema of the left eye. Intraocular pressure was slightly higher than normal, 31 mmHg, in both eyes. The diagnosis of Terson’s syndrome (TS) was made, and the decision was made to follow him conservatively for at least six months.

Unusual intercarotid anastomosis associated with anterior communicating artery aneurysm

1987 ◽  
Vol 67 (5) ◽  
pp. 765-767 ◽  
Author(s):  
Patrick T. Tracy
Keyword(s):  
Carotid Arteries ◽  
Internal Carotid ◽  
Anterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Anterior Communicating Artery Aneurysm ◽  
The Right ◽  
Internal Carotid Arteries ◽  
Angiographic Findings

✓ The case is presented of a 34-year-old man with subarachnoid hemorrhage from rupture of an anterior communicating artery aneurysm. The magnetic resonance imaging and angiographic findings are reported. Angiography showed the aneurysm plus an unusual anastomosis between the intracavernous portions of both internal carotid arteries. The anastomosis crossed posterior to the base of the dorsum sellae and was associated with absence of the right internal carotid artery and the A1 segment of the right anterior cerebral artery. This is the 11th case of such an unusual intercarotid anastomosis reported in the literature.

Abstract 1122‐000086: Comparison of Surgical Clipping vs Endovascular Coiling for Posterior Projecting Anterior Communicating Artery Aneurysm

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Noor Maria
Keyword(s):  
Small Sample Size ◽  
Perioperative Complications ◽  
Postoperative Mortality ◽  
Artery Aneurysm ◽  
Small Sample ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Surgical Clipping ◽  
Mortality And Morbidity ◽  
Anterior Communicating Artery Aneurysm

Introduction : We wanted to evaluate the feasibility and results of endovascular treatment in patients with a posteriorly projecting A Com aneurysm and compare surgical clipping with endovascular coiling for posterior projecting anterior communicating artery aneurysm in terms of peroperative technical feasibility and possible complications such as rupture,perioperative complications and postoperative mortality and morbidity. Methods : .Total 6 cases were studied,3 of them (n = 3, 50%)were operated by surgical clipping and 3 (n = 3.50%) underwent endovascular coiling.Average age was 52yrs, 90% were hypertensive, 80% were smokers. All presented through emergency with subarachnoid hemorrhage.2 of the patients in each surgical and endovascular group presented at ER with Hunt and Hess grade 3 (n = 2,33.3%) the others were at Hunt and Hess grade 2 (n = 4,66.6%). The average time from hemorrhage to surgery and coiling was 25days. Outcome assessed using modified Rankin score and a score of 2 was considered satisfactory. Results : In the surgically treated arm 2 patients had mRS of 2 while the 3 rd one had 4.In the endovascular coiling group 1 had mRS of 1,1 had mRS2 and 3 rd had m RS of 3. Despite the very small sample size the outcome in terms of mRS indicated slightly better results for patients undergoing coiling Conclusion: Endovascular coiling is better in the treatment of posteriorly projecting anterior communicating artery aneurysm. Conclusions : Endovascular coiling is better in the treatment of posteriorly projecting anterior communicating artery aneurysm.

scholarly journals A Novel Treatment of Distal Cerebral Vasospasm

2009 ◽  
Vol 15 (4) ◽  
pp. 417-420 ◽  
Author(s):  
I. Alnaami ◽  
M. Saqqur ◽  
M. Chow
Keyword(s):  
Medical Treatment ◽  
Cerebral Vasospasm ◽  
Balloon Angioplasty ◽  
Artery Aneurysm ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Excellent Outcome ◽  
Clinical Recovery ◽  
Anterior Communicating Artery Aneurysm ◽  
Novel Treatment

A 22-year-old woman had an aneurysmal SAH due to a ruptured anterior communicating artery aneurysm and was treated successfully with endovascular coiling. The patient subsequently developed severe clinical and angiographically distal vasospasm. After failure of both medical treatment and proximal balloon angioplasty, the NeuroFlo™ device was tried and the patient showed substantial clinical recovery. We demonstrated an excellent outcome using a novel treatment for distal cerebral vasospasm with the NeuroFlo™ device.

Decision-making impairment on the Iowa Gambling Task after endovascular coiling or neurosurgical clipping for ruptured anterior communicating artery aneurysm.

2012 ◽  
Vol 26 (2) ◽  
pp. 172-180 ◽  
Author(s):  
Gemma Escartin ◽  
Carme Junqué ◽  
Montserrat Juncadella ◽  
Andreu Gabarrós ◽  
Maria Angels de Miquel ◽  
...  
Keyword(s):  
Decision Making ◽  
Iowa Gambling Task ◽  
Artery Aneurysm ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Gambling Task ◽  
Anterior Communicating Artery Aneurysm

Thrombolysis and Mechanical Fragmentation to Treat Massive Pulmonary Embolism in a Patient with an Anterior Communicating Artery Aneurysm

2003 ◽  
Vol 10 (2) ◽  
pp. 332-335 ◽  
Author(s):  
Ramazan Kutlu ◽  
Alpay Alkan ◽  
Ayhan Kocak ◽  
Kaya Sarac
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Arteries ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Recombinant Tissue Plasminogen Activator ◽  
Massive Pulmonary Embolism ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysm ◽  
The Right ◽  
Mechanical Fragmentation

Purpose: To describe successful management of massive pulmonary embolism suffered by a patient with an unsecured intracranial aneurysm. Case Report: An anterior communicating artery aneurysm was found 10 days after a 50-year-old woman was admitted to the intensive care unit with subarachnoid hemorrhage. The patient developed severe acute dyspnea before planned surgery; imaging demonstrated thrombus in the right and left pulmonary arteries. Heparin was contraindicated, so an emergent coil embolization procedure was undertaken. In the same session, recombinant tissue plasminogen activator was administered directly into the thrombus. After 2 hours of thrombolysis and intermittent mechanical fragmentation, lung perfusion improved, and the patient's symptoms abated. Conclusions: Mechanical fragmentation together with fibrinolytic agent administration is a safe and effective treatment for pulmonary embolism after securing cerebral aneurysms.

Penetration of the optic chiasm by a ruptured anterior communicating artery aneurysm

1997 ◽  
Vol 87 (2) ◽  
pp. 324-326 ◽  
Author(s):  
Isao Date ◽  
Tatsuro Akioka ◽  
akashi Ohmoto
Keyword(s):  
Optic Tract ◽  
Artery Aneurysm ◽  
Optic Chiasm ◽  
Visual Disturbance ◽  
Abrupt Onset ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Anterior Communicating Artery Aneurysm ◽  
Finger Counting ◽  
The Right

✓ There are few reports of anterior communicating artery aneurysms causing visual symptoms, and penetration of the optic chiasm by such aneurysms has not been reported. A 40-year-old man presented with the abrupt onset of left homonymous hemianopsia, right visual acuity disturbance (finger counting), and slight headache. Angiography disclosed a 7-mm anterior communicating artery aneurysm projecting inferiorly. After the neck of the aneurysm was clipped, the dome of the aneurysm was resected. The operation confirmed that the aneurysm had penetrated the right half of the optic chiasm and the thrombosed dome had also compressed the right optic tract. Although the aneurysm was successfully clipped, the visual disturbance persisted after surgery, suggesting that the damage to the visual pathways by aneurysm penetration was irreversible in this case.

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