De novo giant posterior cerebral artery aneurysm developing 25 years after basilar bifurcation aneurysm treatment using a Drake tourniquet: case report and implications for aneurysm follow-up

2018 ◽  
Vol 128 (4) ◽  
pp. 1028-1031
Author(s):  
Rafael Martinez-Perez ◽  
David M. Pelz ◽  
Stephen P. Lownie
Keyword(s):  
Cerebral Artery ◽  
De Novo ◽  
Posterior Cerebral Artery ◽  
Rare Complication ◽  
Young Patients ◽  
Artery Aneurysm ◽  
First Case ◽  
Bifurcation Aneurysm ◽  
De Novo Aneurysm

The objective of this paper was to report a rare complication of basilar artery (BA) tourniquet treatment of a giant basilar tip aneurysm, and to discuss possible causes for the formation of a de novo giant posterior cerebral artery (PCA) aneurysm. A 34-year-old woman underwent satisfactory treatment of a ruptured giant basilar bifurcation aneurysm by BA ligation (Drake tourniquet) in 1985. She presented 25 years later with a new aneurysm in the left PCA, successfully treated by coil embolization. To the authors’ knowledge, this is the first case of de novo aneurysm formation on a PCA, and the first de novo aneurysm reported as a complication of BA ligation therapy by Drake tourniquet. Long-term follow-up is necessary in patients with treated cerebral aneurysms, particularly those occurring in young patients, those with multiple aneurysms, those with complex posterior circulation aneurysms, and those undergoing flow diversion or flow-altering therapies.

De novo distal posterior cerebral artery aneurysm

2003 ◽  
Vol 60 (6) ◽  
pp. 534-539 ◽  
Author(s):  
Hiroyuki Yoshioka ◽  
Takuhiro Hotta ◽  
Eiji Taniguchi ◽  
Naomi Hashimoto ◽  
Yasuyuki Kinoshita ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
De Novo ◽  
Posterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Cerebral Artery Aneurysm

De novo formation and rupture of an azygos pericallosal artery aneurysm

2000 ◽  
Vol 93 (6) ◽  
pp. 1062-1064 ◽  
Author(s):  
Wolfgang Dietrich ◽  
Andrea Reinprecht ◽  
Andreas Gruber ◽  
Thomas Czech
Keyword(s):  
De Novo ◽  
Artery Aneurysm ◽  
Vascular Anomaly ◽  
Content Type ◽  
Pericallosal Artery ◽  
Bifurcation Aneurysm ◽  
Anterior Cerebral Artery Aneurysm ◽  
Cerebral Artery Aneurysm ◽  
Familial Aneurysms

✓ An azygos pericallosal artery (APCA) aneurysm is a rare anomaly that is closely associated with saccular aneurysms. This is the earliest report to document de novo formation and rupture of an aneurysm at the bifurcation of an unpaired pericallosal trunk. The authors report the case of a woman who presented at the age of 52 years with subarachnoid hemorrhage (SAH) from the rupture of a newly formed APCA bifurcation aneurysm, 7 years after she had undergone surgery to clip a ruptured anterior cerebral artery aneurysm. De novo formation of aneurysms after SAH rarely occurs and certain risk factors like multiple and familial aneurysms, arterial hypertension, or smoking have been postulated. Late follow-up examination with angiography to detect de novo aneurysms should be considered in patients with this vascular anomaly after SAH.

scholarly journals Necessity of follow-up cerebral digital subtraction angiography after endovascular coiling or microsurgical cliping of ruptured intracranial aneurysms to exclude de novo or aneurysmal regrow and avoid its rupture: report of 2 cases

2019 ◽  
Vol 27 (1) ◽  
pp. 12-20
Author(s):  
D.J. Gunia ◽  
E.T. Ekvtimishvili ◽  
G.Z. Basiladze
Keyword(s):  
Digital Subtraction Angiography ◽  
Intracranial Aneurysms ◽  
De Novo ◽  
Anterior Communicating Artery ◽  
Digital Subtraction ◽  
Treatment Results ◽  
First Case ◽  
De Novo Aneurysm ◽  
Brain Aneurysms

Objective – to improve treatment results of patients with ruptured brain aneurysms using follow-up cerebral digital subtraction angiography to avoid de novo or aneurismal regrow.Materials and methods. Analysis of follow-up cerebral digital subtraction angiography and treatment results of two patient (60 and 64-year-old females) with brain anterior communicated artery de novo aneurysm and regrowed aneurysm of an anterior communicated artery after microsurgical clipping.Results. Two patient underwent endovascular treatment of ruptured brain aneurysms after non follow-up cerebral digital subtraction angiography. In first case de novo aneurysm of anterior communicating artery and in second – regrowed aneurys of anterior communicating artery after surgical clipping. Both patients were discharged from the clinic in I and IV modified Rankin scale. Conclusions. Digital subtraction angiography follow-up of intracranial aneurysms treated by endovascular or microsurgical approach is important for the detection and prediction for the risk of bleeding (aneurysm recurrence and de novo aneurysm). There exist no guidelines on the frequency of monitoring and imaging modality to adopt and the monitoring is adapted on a case-by-case basis. Digital subtraction angiography is the gold standard for the evaluation of aneurysmal occlusion after coiling and microsurgical clipping and remains also necessary for evaluating other devices.

Sinking skin flap syndrome in a patient with giant thrombosed posterior cerebral artery aneurysm: a case report

2017 ◽  
Vol 31 (2) ◽  
pp. 186-190
Author(s):  
Ona Lapteva ◽  
Ugnius Ksanas ◽  
Jelena Scerbak
Keyword(s):  
Cerebral Artery ◽  
Decompressive Craniectomy ◽  
Cerebral Autoregulation ◽  
Posterior Cerebral Artery ◽  
Cerebral Metabolism ◽  
Rare Complication ◽  
Skin Flap ◽  
Artery Aneurysm ◽  
Aneurysm Clipping ◽  
Cerebral Artery Aneurysm

Abstract Sinking skin flap syndrome is a rare complication following decompressive craniectomy. The pathogenesis is based on disturbed cerebral autoregulation and as a consequence dicreased CBF and cerebral metabolism. This results in neurologic disturbances, i. e. mental changes and focal deficits. The authors present the patient who developed the motor trephine syndrome after decompressive craniectomy following complicated giant posterior cerebral artery aneurysm clipping.

scholarly journals Stent-assisted coil embolization of a recurrent posterior cerebral artery aneurysm following surgical clipping

2016 ◽  
Vol 30 (1) ◽  
pp. 99-103 ◽  
Author(s):  
Tomonori Takeshita ◽  
Tomoaki Nagamine ◽  
Kohei Ishihara ◽  
Yasuhiko Kaku
Keyword(s):  
Cerebral Artery ◽  
Coil Embolization ◽  
Posterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Parent Artery ◽  
Surgical Clipping ◽  
Substantial Risk ◽  
Multiple Recurrences ◽  
Cerebral Artery Aneurysm

Posterior cerebral artery (PCA) aneurysms are rare, and direct surgery of these is considered difficult. Coil embolization of PCA aneurysms is becoming popular. However, it is difficult to completely obliterate the aneurysm while preserving the flow of the parent artery in large or giant PCA aneurysms with a wide neck with this technique. We report a case of a large and wide-necked PCA aneurysm with multiple recurrences following successful surgical clipping and coil embolization. A 77-year-old man with a large unruptured right PCA (P2) aneurysm was successfully treated by surgical clipping. Postoperative digital subtraction angiography (DSA) showed complete aneurismal occlusion. Four years afterward, the aneurysm recurred and grew toward the contralateral. Surgical retreatment of this complicated aneurysm was considered difficult, with a substantial risk of complications. Therefore, the aneurysm was treated with an endovascular procedure. Because simple coil embolization was not expected to achieve satisfactory obliteration of the aneurysm with preservation of parent artery patency, we used stent-assisted coil embolization. The patient tolerated the treatment well. On DSA obtained six months after the first endovascular treatment, coil compaction and recanalization of the aneurysm were detected. A second coil embolization was successfully performed without any complications. The aneurysm was stable during the next six-month follow-up. Stent-assisted coil embolization may be feasible and effective for such postoperatively complicated aneurysms.

scholarly journals Optional Endovascular Therapy of Dissecting Posterior Cerebral Artery Aneurysm

2017 ◽  
Vol 6 (3-4) ◽  
pp. 219-228 ◽  
Author(s):  
Mohamed Wael Osman ◽  
Krzysztof Kadziolka ◽  
Laurent Peirot
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Artery ◽  
Endovascular Therapy ◽  
Posterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Occurrence Rate ◽  
Parent Artery ◽  
Safe Method ◽  
First Case ◽  
History Of

Background: Posterior cerebral artery aneurysms are uncommon, with an occurrence rate of less than 1% of intracranial aneurysms. They have various shapes, including saccular and fusiform. Dissecting aneurysms may occur in distal posterior cerebral artery and they may affect the whole artery. Endovascular therapy is considered as a safe method of treatment and there are different techniques for endovascular therapy. Summary: Posterior cerebral artery aneurysms are uncommon. Endovascular therapy is considered as a safe method of treatment and there are different techniques for endovascular therapy. We present here three cases collected from Maison Blanche Hospital (Intervention Neuroradiology Department, CHU Reims, France) during 2011-2012; they were females, at a young age and the affected side was on the right. The first case was affected at the P2-P3 segment, the aneurysm was fusiform in shape and she presented with ischemic stroke, while the second and third cases were affected at the P2 segment, the aneurysms being saccular in shape; one of them presented with subarachnoid hemorrhage with a history of migraine and the other patient presented with ischemic stroke. All of them had no history of trauma, hypertension or other diseases. One patient was treated by coiling and sacrificing the parent artery, the second patient was treated with stent-assisted coils, and the third one was treated by coiling without sacrificing the parent artery.

scholarly journals Treatment of a middle cerebral artery bifurcation aneurysm with the novel Contour Neurovascular System compatible with 0.021″ catheters

2021 ◽  
pp. 197140092110415
Author(s):  
Maximilian Thormann ◽  
Anastasios Mpotsaris ◽  
Daniel Behme
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Artery Aneurysm ◽  
Flow Diverter ◽  
The Novel ◽  
Bifurcation Aneurysm ◽  
The Right

Background For wide-necked intracranial aneurysms, endo-saccular flow disruption can be a viable alternative to coiling or flow diverters. The Contour Neurovascular System is an intrasaccular flow diverter device targeting the neck of the aneurysm. Until now, the system had to be delivered through a 0.027″ microcatheter. We report the first implantation and follow-up of the novel Contour 021 system compatible with 0.021″ microcatheters. Case presentation: A 54-year-old male patient presented with an unruptured right middle cerebral artery aneurysm at the right temporopolar branch. Existing medication included apixaban. An arteriogram showed a broad-based aneurysm. Due to its asymmetric geometry, neither the Woven EndoBridge nor stent-assisted coil embolisation were regarded as promising treatment strategies. To uphold the option of different treatment options, prasugrel 10 mg was initiated before treatment. Implantation was performed under general anaesthesia via femoral artery puncture. A 0.021″ Headway™ catheter was used for accessing the aneurysm. The Contour device was oversized to the equatorial plane. Deployment was successful with only one attempt without the need for re-sheathing. Follow-up catheter angiography was performed after three months, showing complete occlusion of the aneurysm. No procedure-related complications occurred. Conclusion The 0.021 design of the Contour enlarges the subgroup of patients that can be treated with endo-saccular devices and will enable treatment of smaller and more distal aneurysms.

scholarly journals Delayed development of a de novo contralateral middle cerebral artery aneurysm in a patient with hyperimmunoglobulin E syndrome: A case report

2019 ◽  
Vol 25 (4) ◽  
pp. 442-446 ◽  
Author(s):  
Eric S Nussbaum ◽  
Collin M Torok ◽  
Jason Carroll ◽  
Allicia M Gunderman
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
De Novo ◽  
Artery Aneurysm ◽  
Left Middle Cerebral Artery ◽  
Cross Sectional ◽  
Microsurgical Clipping ◽  
Hyperimmunoglobulin E Syndrome ◽  
Bifurcation Aneurysm ◽  
Increased Risk

A 50-year-old female patient with hyperimmunoglobulin E syndrome (HIES) presented initially at the age of 48 years with subarachnoid hemorrhage (SAH) from a ruptured left middle cerebral artery (MCA) bifurcation aneurysm, which was treated successfully with coiling and microsurgical clipping. Angiography and cross-sectional imaging did not indicate evidence of any additional intracranial aneurysm. However, the patient presented two years later with SAH secondary to a new ruptured right MCA bifurcation aneurysm, which was treated successfully with microsurgical clipping. This case provides further evidence that HIES places the cerebral vasculature at increased risk for cerebral aneurysm formation and that special considerations are indicated in managing and monitoring these patients.

scholarly journals Late Coil Migration after Embolization of Cerebral Aneurysms – Case Series

2018 ◽  
Vol 37 (01) ◽  
pp. 71-75
Author(s):  
Luana Antunes Maranha Gatto ◽  
Luana Bandeira Rocha ◽  
Gelson Koppe ◽  
Zeferino Demartini Jr
Keyword(s):  
Cerebral Artery ◽  
Rare Complication ◽  
Case Series ◽  
Artery Aneurysm ◽  
Neurological Deficits ◽  
Unruptured Aneurysms ◽  
First Case ◽  
Aneurysm Embolization ◽  
Left Posterior ◽  
Coil Migration

Background Coil migration after cerebral aneurysm embolization is a very rare complication. It can take place early or late in the postoperative period, evolving asymptomatic and causing severe neurological deficits. Ruptured aneurysms of anterior communicant artery were the most frequent reported examples in the literature. Case Report We report three cases of patients with unruptured aneurysms treated with coils and remodeling balloon technique. The first case was that of a left posterior communicating artery aneurysm with coil migration to a distal cortical branch of ipsilateral middle cerebral artery (MCA). The patient had mild paresthesia in the arm for a few days. The second one was a fenestrated basilar artery aneurysm with coil migration to the P2 segment of the left posterior cerebral artery. The patient was fully asymptomatic. The third case was a MCA aneurysm with coil migration to the M3 segment. There were no ischemic complications, and all patients underwent a new endovascular procedure. Conclusions Coil migration is a rare but not always severe complication. Antiplatelet agents are recommended even if the coil migration is asymptomatic.

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