scholarly journals Coiling for an unruptured saccular aneurysm at the non-branching segment of the distal anterior cerebral artery: Case report and literature review

2020 ◽  
Vol 33 (2) ◽  
pp. 140-144
Author(s):  
Kazushi Maeda ◽  
Yosuke Kawano ◽  
Naoki Maehara ◽  
Yuhei Michiwaki ◽  
Shintaro Nagaoka ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Coil Embolization ◽  
Anterior Cerebral Artery ◽  
Side Wall ◽  
Medical Checkup ◽  
Marginal Artery ◽  
First Case ◽  
Rare Location ◽  
The Right ◽  
Distal Anterior Cerebral Artery

Background Saccular aneurysms in the non-branching segment of the distal anterior cerebral artery (DACA) are extremely rare. Here, we describe the first case of coil embolization using a simple, non-adjunctive technique for an aneurysm at this rare location. Case description A 74-year-old man with an asymptomatic, unruptured aneurysm of the right DACA was followed up annually for 3 years by medical checkup. Endovascular treatment was proposed because of a slight angiographic change in the shape of the aneurysm in the past year. The aneurysm at the non-branching site of the right calloso-marginal artery was 2 mm distal to the origin, and measured 3 mm in height and 3.3 mm in width, with a neck measuring 1.7 mm wide; the calloso-marginal artery diameter was 1.6 mm. The aneurysm was successfully embolized with a simple technique using a Pre-Shaped S Microcatheter and two coils. Conclusions The simple, non-adjunctive technique for coil embolization of saccular side-wall type aneurysm in the non-branching segment of the DACA could be performed using the appropriate catheter and a softer coil.

scholarly journals A case of delayed distal coil migration after coil embolization of an unruptured distal azygos anterior cerebral artery aneurysm: A case report and literature review

2018 ◽  
Vol 24 (6) ◽  
pp. 643-649 ◽  
Author(s):  
Kazushi Maeda ◽  
Ryota Motoie ◽  
Satoshi Karashima ◽  
Ryosuke Otsuji ◽  
Nice Ren ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Artery ◽  
Coil Embolization ◽  
Anterior Cerebral Artery ◽  
Artery Aneurysm ◽  
First Case ◽  
Number Of Patients ◽  
Treatment Knowledge ◽  
Ischemic Complications ◽  
Coil Migration

Intraprocedural coil migration during endovascular treatment for an aneurysm that might carry serious ischemic complications is well known. On the other hand, delayed coil migration after endovascular treatment for an aneurysm is very rare. A 77-year-old woman was incidentally diagnosed with unruptured aneurysm associated with distal azygos anterior cerebral artery (ACA). The aneurysm was located at the distal bifurcation of the azygos ACA and was wide necked (approximately 7 mm in diameter). Endovascular coil embolization was selected and the aneurysm was occluded successfully, but 29 days after endovascular therapy, follow-up computed tomography (CT) and magnetic resonance (MR) angiography revealed distal coil migration in the peripheral portion of the ACA. In addition, CT on day 57 after therapy revealed the migrated coil had moved more distally. Fortunately, in the course of these events, the patient remained asymptomatic. To the best of our knowledge, this represents the first case of delayed distal coil migration associated with relatively rare azygos ACA aneurysm, and also the first report confirming more distal coil movement over time. In the future, a large number of patients could develop this complication as more aneurysms are aggressively treated with endovascular treatment. Knowledge regarding the possibility of delayed coil migration is thus important.

Superficial Temporal Artery Extended Interposition Graft to Anterior Cerebral Artery Bypass for the Treatment of a Large Fusiform Distal Anterior Cerebral Artery Aneurysm: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Bhanu Jayanand Sudhir ◽  
Sanjay Honavalli Murali ◽  
Mohamed Amjad Jamaluddin ◽  
Easwer Hariharan Venkat
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Uneventful Recovery ◽  
Interposition Graft ◽  
Marginal Artery ◽  
Fisher Grade ◽  
Distal Anterior Cerebral Artery

Abstract Fusiform aneurysms of the distal anterior cerebral artery (DACA) are infrequent. Clip reconstruction and sequential progressive clipping have been described in the management of giant thrombosed DACA aneurysms.1,2 Customized revascularization with bypass, side-to-side anastomosis, and trapping of the aneurysmal segment have also been performed for treating DACA aneurysms.3-12 We present a 2-dimensional operative video of superficial temporal artery (STA) to distal anterior cerebral artery bypass, followed by trapping of the aneurysm-bearing segment. A 57-yr-old lady presented with a large ruptured subcallosal fusiform DACA aneurysm (WFNS grade 1, Fisher grade 1). Angiography revealed a 1.3 × 0.9 cm fusiform aneurysm in the DACA.  Informed consent was secured from the patient and her family for the surgery and permission was obtained for the publication of the patient's image/surgical video. The frontal and parietal branches of the STA were dissected. The parietal branch was explanted and used as a free interposition graft between the frontal branch (end-to-end anastomosis) and calloso-marginal artery (end-to-side anastomosis). After confirming blood flow through the bypass using Doppler, the aneurysm was trapped and excised.  The patient had an uneventful recovery. Her postoperative computed tomography (CT) head revealed no evidence of neurological insult. The patency of the bypass conduit and the complete removal of the aneurysm were confirmed using a digital subtraction angiogram. Histopathological examination revealed an eccentric atheromatous plaque with a lipid core. There was no evidence of intraplaque hemorrhage. This extended STA graft utilizing the frontal and parietal branches of the STA, and its implantation into the distal ACA, offers a novel bypass strategy for tackling fusiform aneurysms of the DACA. Anastomosis to the calloso-marginal artery ensured perfusion of the ACA territory through the pericallosal artery during temporary occlusion.

Aneurysm of the distal anterior cerebral artery radiologically mimicking a ventricular mass

2011 ◽  
Vol 114 (4) ◽  
pp. 1061-1064 ◽  
Author(s):  
A. Metin Şanlι ◽  
Saruhan Çekirge ◽  
Zeki Şekerci
Keyword(s):  
Cerebral Artery ◽  
Lateral Ventricle ◽  
Anterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Ventricular Mass ◽  
Frontal Horn ◽  
Major Branch ◽  
The Right ◽  
Distal Anterior Cerebral Artery ◽  
Cerebral Artery Aneurysm

The ventricular system is a rare localization for intracranial aneurysms. Most ventricular aneurysms arise from a distal branch of the choroidal arteries and a major branch point of the circle of Willis. A 41-year-old-man suffering from dizziness of 2 weeks' duration was admitted to the clinic. On radiological examination, he had a well-circumscribed mass involving the frontal horn of the right lateral ventricle without radiological evidence of a prior or recent hemorrhage. Localization and radiological appearance were not typical of a ventricular mass and did not allow diagnosis. After cerebral angiography, an aneurysm arising from the distal anterior cerebral artery was incidentally found in an intraventricular location. This unruptured aneurysm was successfully treated via the endovascular route. The authors describe the unusual case of a distal anterior cerebral artery aneurysm with a dome extending into the right lateral ventricle, which appears to be the first such case in the literature. Angiography may be helpful to neurosurgeons in avoiding the disastrous complications of a biopsy procedure in such unusual cases.

Microsurgical Treatment of Distal Anterior Cerebral Artery Aneurysms: 3-Dimensional Operative Video

2018 ◽  
Vol 16 (1) ◽  
pp. E16-E16
Author(s):  
Vijay Agarwal ◽  
Daniel L Barrow
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Vascular Anomaly ◽  
Vertical Position ◽  
Parent Artery ◽  
Developmental Venous Anomaly ◽  
Intraoperative Angiography ◽  
The Right ◽  
Distal Anterior Cerebral Artery

Abstract Selecting appropriate patient position for surgery must take into consideration a variety of factors. For an interhemispheric approach to distal anterior cerebral artery (DACA) aneurysms, the patient may be positioned with the head either horizontal or vertical with respect to the floor. We preferentially place the patient in the supine position with the shoulder elevated and the head turned parallel to the floor with the side of the approach down and the vertex tilted 45° up. In this way, gravity is utilized to allow the right frontal lobe to fall away from the falx, eliminating the need for retraction. To demonstrate the importance of individualizing the choice of position to each patient, we present here 2 illustrative cases of DACA aneurysms in which different positioning was selected. One patient presented with a 7-mm bilobed pericallosal artery aneurysm; the aneurysm was approached with the head horizontal with respect to the floor. The second patient had a 3-mm DACA aneurysm and a right frontal proliferative angiopathy and developmental venous anomaly with evidence of prior hemorrhage. Due to the vascular anomaly, we positioned the head in a vertical position for surgery to clip the aneurysm, which was thought to be the source of hemorrhage. The videos illustrate the approach to DACA aneurysms, which typically exposes the aneurysm before complete exposure of the proximal parent artery is obtained. In one case, the use of both frameless guidance and intraoperative angiography was useful in identifying a small previously ruptured aneurysm.  All appropriate patient consents were obtained for this submission.  Video and Figures (0:57-1:16 and 6:30-6:37), © 2017 Department of Neurosurgery, Emory University. Used with permission.

scholarly journals Treatment of an anterior cerebral artery pseudoaneurysm secondary to a transsphenoidal surgery using stent-assisted coiling

2021 ◽  
Vol 12 ◽  
pp. 20
Author(s):  
Atsushi Ishida ◽  
Keizoh Asakuno ◽  
Masataka Kato ◽  
Hideki Shiramizu ◽  
Haruko Yoshimoto ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Transsphenoidal Surgery ◽  
Internal Carotid ◽  
Anterior Cerebral Artery ◽  
Parent Artery ◽  
Case Description ◽  
Artery Pseudoaneurysm ◽  
First Case ◽  
Collateral Vessels ◽  
The Right

Background: Injury of the internal carotid artery (ICA) during transsphenoidal surgery (TSS) is a rare but critical complication. There are several reports on endovascular treatment of ICA injury during TSS. With the recent flourishing of extended TSS, injuries to the distal arteries such as the anterior cerebral artery (ACA) are more likely to occur. Case Description: In the present case, we report a pseudoaneurysm of the right ACA due to injury during extended TSS for aggressive prolactinoma. Due to the absence of collateral vessels, the pseudoaneurysm had to be obliterated while preserving the parent artery. Hence, we decided to treat the pseudoaneurysm using stent-assisted coiling (SAC). The pseudoaneurysm was completely obliterated and he was discharged without any complications. Conclusion: To the best of our knowledge, this is the first case in which an ACA pseudoaneurysm caused by injury during the TSS was treated with SAC and the parent artery was preserved.

scholarly journals Mirror Image Distal Anterior Cerebral Artery Aneurysms Treated with Coil Embolization

2013 ◽  
Vol 19 (1) ◽  
pp. 49-55 ◽  
Author(s):  
E. Enesi ◽  
A. Rroji ◽  
M. Demneri ◽  
G. Vreto ◽  
M. Petrela
Keyword(s):  
Case Report ◽  
Endovascular Treatment ◽  
Coil Embolization ◽  
Anterior Cerebral Artery ◽  
Cerebral Arteries ◽  
Mirror Image ◽  
Anterior Communicating Artery ◽  
First Case ◽  
Anatomic Variants ◽  
Distal Anterior Cerebral Artery

Mirror image aneurysms of the distal anterior cerebral arteries (DACA) are rare. To the best of our knowledge this is the first case report of two patients with mirror image DACA aneurysms treated successfully with coil embolization. The association of aneurysms with anatomic variants has been extensively reported. We may speculate that the remnants of the failed regression of the supreme anterior communicating artery could lead to an increase in stress across their territorial bifurcation, leading to the development of mirror image DACA aneurysms. We found the endovascular treatment of mirror image DACA aneurysms to be feasible and effective. If possible, we suggest the treatment of both aneurysms in one procedure.

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