Giant Pseudoaneurysm of the Extracranial Vertebral Artery Successfully Treated Using Intraoperative Balloon Catheters

Neurosurgery ◽  
1991 ◽  
Vol 28 (5) ◽  
pp. 738-742 ◽  
Author(s):  
Junya Hanakita ◽  
Hideyuki Suwa ◽  
Kiyoshi Nishihara ◽  
Koji Iihara ◽  
Hiroshi Sakaida
Keyword(s):  
Vertebral Artery ◽  
Cardiac Pacemaker ◽  
Innominate Artery ◽  
Anatomical Location ◽  
High Morbidity ◽  
Vertebrobasilar System ◽  
Balloon Catheters ◽  
Extracranial Vertebral Artery ◽  
The Right ◽  
Giant Pseudoaneurysm

Abstract Traumatic pseudoaneurysms of the extracranial vertebral artery rarely occur, because of its deeply protected anatomical location. Because the direct surgical approach has resulted in high morbidity and mortality rates, ligation of the vertebral artery has been adopted, but this can cause an ischemia in the vertebrobasilar system. We report the case of a 73-year-old woman with a huge pseudoaneurysm of the right vertebral artery that occurred after attempted placement of a cardiac pacemaker. The aneurysm was 7 x 7 x 5 cm in size and its neck was situated just distal to the right subclavian artery. Direct surgical repair of the injured vessel and removal of the aneurysm were successfully performed using balloon catheters placed intraoperatively in both the innominate artery and the right vertebral artery.

scholarly journals Reversal of Blood Flow in the Right Vertebral Artery Accompanying Occlusion of the Innominate Artery

1965 ◽  
Vol 161 (3) ◽  
pp. 353-356 ◽  
Author(s):  
WILLIAM S. BLAKEMORE ◽  
WILLIAM H. HARDESTY ◽  
JOHN E. BEVILACQUA ◽  
THEODORE A. TRISTAN
Keyword(s):  
Blood Flow ◽  
Vertebral Artery ◽  
Innominate Artery ◽  
The Right

An unusual case of a giant extracranial vertebral artery aneurysm

Vascular ◽  
2019 ◽  
Vol 27 (4) ◽  
pp. 427-429 ◽  
Author(s):  
Abd Elaziz A Suliman ◽  
Hytham KS Hamid ◽  
Salwa O Mekki
Keyword(s):  
Vertebral Artery ◽  
Symptomatic Relief ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Mass Effect ◽  
Posterior Neck ◽  
Post Traumatic ◽  
Extracranial Vertebral Artery ◽  
The Right ◽  
Significant Mass Effect

Objective Extracranial vertebral artery (VA) aneurysms are rare and are often post-traumatic secondary to penetrating or blunt injuries. Primary extracranial VA aneurysms are far less common. Most of these lesions are located in the proximal (V1) and middle (V2) segments of the VA. Method We report an extremely rare case of a giant aneurysm of the extracranial vertebral artery in a 50-year-old woman who presented with a right posterior neck swelling, headache and pain at the site of the mass. Angiography confirmed aneurysm of V3 segment of the right VA. Treatment included ligation of the artery and aneurysmectomy. Result Magnetic resonance angiography at 12 months showed obliterated proximal segment of the right VA with no obvious flow distally. Conclusion Aneurysms of the extracranial VA are clinically relevant because of the associated risks of rupture and distal embolization. For patients with rupture, pending rupture or a significant mass effect due to a giant lesion, surgery is the treatment modality of choice to attain symptomatic relief.

scholarly journals Atypical presentation of rotational vertebral artery insufficiency: illustrative case

2021 ◽  
Vol 1 (9) ◽  
Author(s):  
Pranish A. Kantak ◽  
Sarv Priya ◽  
Girish Bathla ◽  
Mario Zanaty ◽  
Patrick W. Hitchon
Keyword(s):  
Vertebral Artery ◽  
Facet Joint ◽  
Head Rotation ◽  
Rotational Instability ◽  
Anatomical Location ◽  
Illustrative Case ◽  
Vertebrobasilar Insufficiency ◽  
Course Of Action ◽  
Heterogeneous Nature ◽  
The Right

BACKGROUNDRotational vertebral artery insufficiency (RVAI), also known as bow hunter’s syndrome, is an uncommon cause of vertebrobasilar insufficiency that leads to signs of posterior circulation ischemia during head rotation. RVAI can be subdivided on the basis of the anatomical location of vertebral artery compression into atlantoaxial RVAI (pathology at C1-C2) or subaxial RVAI (pathology below C2). Typically, RVAI is only seen with contralateral vertebral artery pathologies, such as atherosclerosis, hypoplasia, or morphological atypia.OBSERVATIONSThe authors present a unique case of atlantoaxial RVAI due to rotational instability, causing marked subluxation of the C1-C2 facet joints. This case is unique in both the mechanism of compression and the lack of contralateral vertebral artery pathology. The patient was successfully treated with posterior C1-C2 instrumentation and fusion.LESSONSWhen evaluating patients for RVAI, neurosurgeons should be aware of the variety of pathological causes, including rotational instability from facet joint subluxation. Due to the heterogeneous nature of the pathologies causing RVAI, care must be taken to decide if conservative management or surgical correction is the right course of action. Because of this heterogeneous nature, there is no set guideline for the treatment or management of RVAI.

scholarly journals Vertebrobasilar System in the European Hare

2016 ◽  
Vol 60 (2) ◽  
pp. 20-23
Author(s):  
S. Flešárová ◽  
D. Maženský
Keyword(s):  
Spinal Cord ◽  
Vertebral Artery ◽  
Cervical Spinal Cord ◽  
High Variability ◽  
Arterial System ◽  
Corrosion Casting ◽  
European Hare ◽  
Vertebral Arteries ◽  
Vertebrobasilar System ◽  
The Right

Abstract The aim of this study was to describe the arterial arrangement of the cervical spinal cord in the hare using the corrosion technique. The study was carried out on 10 adult European hares (Lepus Europeus). The arterial system of the cervical spinal cord was injected using Batson’s corrosion casting kit No. 17. The fusion of the bilateral vertebral arteries was found in 70% of the cases without a connecting branch and in 30% of the cases with one connecting branch just posterior to the fusion. The ventral spinal artery was in connection with the right vertebral artery in 60% of the cases and by means of an anastomosis of two spinal branches arising from the bilateral vertebral arteries in 40% of the cases. Based on the results of this study, it is possible to conclude that there is a high variability of the blood supply to the cervical part of the spinal cord in the hare.

Direct Repair of an Extracranial Vertebral Artery Pseudoaneurysm: Case Report and Review of the Literature

Neurosurgery ◽  
1990 ◽  
Vol 26 (3) ◽  
pp. 528-533 ◽  
Author(s):  
R. A. de los Reyes ◽  
Franklin G. Moser ◽  
David P. Sachs ◽  
Harrison F. Boehm
Keyword(s):  
Case Report ◽  
Vertebral Artery ◽  
Posterior Longitudinal Ligament ◽  
Vascular Repair ◽  
Review Of The Literature ◽  
Artery Pseudoaneurysm ◽  
Cervical Hematoma ◽  
Direct Repair ◽  
Extracranial Vertebral Artery ◽  
The Right

Abstract A case of a 47-year-old man with weakness secondary to ossification of the posterior longitudinal ligament is presented. During removal of the ossified ligament, the patient's dominant right vertebral artery was injured. Although the bleeding from this artery was controlled intraoperatively, the patient developed an expanding cervical hematoma on the 3rd postoperative day. An angiogram demonstrated a large pseudoaneurysm of the right vertebral artery. The patient was taken back to the operating room where the cervical hematoma was removed, and direct repair of the pseudoaneurysm of the vertebral artery was performed. The previously reported cases of pseudoaneurysms of the extracranial vertebral artery are reviewed. We advocate the use of direct vascular repair as the treatment of choice in these lesions.

Intravascular ultrasonography-guided stent angioplasty of an extracranial vertebral artery dissection

2008 ◽  
Vol 109 (6) ◽  
pp. 1113-1118 ◽  
Author(s):  
Won-Ki Yoon ◽  
Young-Woo Kim ◽  
Sang-Don Kim ◽  
Ik-Seong Park ◽  
Min-Woo Baik ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Coil Embolization ◽  
Posterior Inferior Cerebellar Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Intravascular Ultrasonography ◽  
Stent Angioplasty ◽  
Posterior Neck ◽  
Extracranial Vertebral Artery ◽  
The Right

The authors report on a case of intravascular ultrasonography (IVUS)-guided stent angioplasty for iatrogenic extracranial vertebral artery (VA) dissection in a 49-year-old man after coil embolization for an unruptured aneurysm of the right posterior inferior cerebellar artery. Insignificant dissections occurred during the procedure. Postoperatively, the patient experienced gradually worsening posterior neck pain and headache, and follow-up angiography 8 months after the coil embolization revealed expansion of the dissection. The patient underwent stent angioplasty with IVUS guidance and his symptoms improved. To the authors' knowledge, this is the first report of IVUS-guided stent angioplasty of an extracranial VA dissection. It was safe and feasible to treat extracranial VA dissections with stent placement under IVUS guidance. Intravascular environments are in real time with IVUS, and this technique is useful in the confirmation of a true lumen and evaluation of appropriate stent apposition. More clinical experience with this technique is necessary and mandatory, and devices with smaller diameters with improved trackability are essential for further introduction of IVUS into the field of endovascular neurosurgery.

scholarly journals Giant pseudoaneurysm of the extracranial vertebral artery: case report

1996 ◽  
Vol 54 (2) ◽  
pp. 297-303 ◽  
Author(s):  
Pasquale Gallo ◽  
Amauri Dalacorte ◽  
Eduardo Raupp ◽  
Amir J. Santos ◽  
Marcos R. C. Frank ◽  
...  
Keyword(s):  
Case Report ◽  
Vertebral Artery ◽  
Cerebellopontine Angle ◽  
Firearm Injuries ◽  
Extracranial Vertebral Artery ◽  
Endovascular Approach ◽  
Deep Location ◽  
Giant Pseudoaneurysm

Pseudoaneurysms of the extracranial vertebral artery are extremely rare due to their deep location and the anatomical protection of this artery. They can be caused by cervical traumas (firearm injuries, sports, hyperextension of the neck and iatrogeny). The authors report the case of a patient who developed a giant pseudoaneurysm of the extracranial vertebral artery after surgery for the removal of a tumor of the cerebellopontine angle in which surgical lesion of the artery occurred. Treatment was performed by endovascular approach. Literature is reviewed and comments are made on the physiopathogeny of the lesion and the different forms of treatment.

scholarly journals Chronic fusiform extracranial vertebral artery aneurysm with recurrent posterior circulation emboli: Case report and review of the literature

2021 ◽  
pp. 159101992110185
Author(s):  
Katherine Evans ◽  
Ralf-Björn Lindert ◽  
Richard Dyde ◽  
George H Tse
Keyword(s):  
Vertebral Artery ◽  
Artery Aneurysm ◽  
Posterior Circulation ◽  
Vascular Plug ◽  
Procedural Complication ◽  
Independent Life ◽  
Extracranial Vertebral Artery ◽  
Aneurysm Occlusion ◽  
The Right ◽  
Proximal Occlusion

We report a case of a 64-year-old man with a fusiform right extracranial vertebral artery aneurysm, spanning over half the extra-cranial V2 (foraminal) segment, presenting with recurrent multi-focal posterior circulation embolic ischaemic stroke. The patient was treated with endovascular embolisation of the right vertebral artery to prevent further thrombo-embolic events. Distal and proximal occlusion of the aneurysmal vertebral artery was performed with a micro-vascular plug with partial aneurysm sack embolisation to aid thrombosis and reduce the risk of recanalisation. Two months post procedure MR angiography confirmed successful aneurysm occlusion with no post-procedural complication. The patient returned to his normal independent life. Endovascular treatment with vessel sacrifice is an effective treatment with low morbidity and we believe the MVP device to be a efficacious option in the vertebral artery.

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