scholarly journals Enlargement and Fatal Rupture of A Fusiform Aneurysm Arising from Megadolichobasilar Anomaly : Mechanism of Aneurysmal Enlargement and Its Treatment

1994 ◽  
Vol 3 (3) ◽  
pp. 247-253 ◽  
Author(s):  
Yutaka Honma ◽  
Seigo Nagao ◽  
Shinji Takeuchi
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Chen Li ◽  
Ao-Fei Liu ◽  
Han-Cheng Qiu ◽  
Xianli Lv ◽  
Ji Zhou ◽  
...  

Abstract Background Treatment of perforator involving aneurysm (piAN) remains a challenge to open and endovascular neurosurgeons. Our aim is to demonstrate a primary outcome of endovascular therapy for piANs with the use of perforator preservation technologies (PPT) based on a new neuro-interventional classification. Methods The piANs were classified into type I: aneurysm really arises from perforating artery, type II: saccular aneurysm involves perforating arteries arising from its neck (IIa) or dome (IIb), and type III: fusiform aneurysm involves perforating artery. Stent protection technology of PPT was applied in type I and III aneurysms, and coil-basket protection technology in type II aneurysms. An immediate outcome of aneurysmal obliteration after treatment was evaluated (satisfactory obliteration: the saccular aneurysm body is densely embolized (I), leaving a gap in the neck (IIa) or dome (IIb) where the perforating artery arising; fusiform aneurysm is repaired and has a smooth inner wall), and successful perforating artery preservation was defined as keeping the good antegrade flow of those perforators on postoperative angiography. The periprocedural complication was closely monitored, and clinical and angiographic follow-ups were performed. Results Six consecutive piANs (2 ruptured and 4 unruptured; 1 type I, 2 type IIa, 2 type IIb, and 1 type III) in 6 patients (aged from 43 to 66 years; 3 males) underwent endovascular therapy between November 2017 and July 2019. The immediate angiography after treatment showed 6 aneurysms obtained satisfactory obliteration, and all of their perforating arteries were successfully preserved. During clinical follow-up of 13–50 months, no ischemic or hemorrhagic event of the brain occurred in the 6 patients, but has one who developed ischemic event in the territory of involving perforators 4 h after operation and completely resolved within 24 h. Follow-up angiography at 3 to 10M showed patency of the parent artery and perforating arteries of treated aneurysms, with no aneurysmal recurrence. Conclusions Our perforator preservation technologies on the basis of the new neuro-interventional classification seem feasible, safe, and effective in protecting involved perforators while occluding aneurysm.


2021 ◽  
pp. 159101992110251
Author(s):  
Hyun Ho Choi ◽  
Young Dae Cho ◽  
Dong Hyun Yoo ◽  
Hyun-Seung Kang ◽  
Moon Hee Han

Stenting of vertebral artery dissecting aneurysms (VADAs) may promote mural apposition of intimal flaps, preserving the patency of injured vessels. Moreover, stent deployment may serve to alter intra-aneurysm flow, inducing saccular thrombus formation, neointimal development, and remodeling of injured vessels. Although an overlapping multistent strategy with coiling has proven successful in this setting, yielding good anatomic and clinical outcomes, coiling may be technically infeasible in some VADAs with unfavorably configured circumferential elevations. Herein, we describe three patients with VADAs for whom coiling was deemed technically problematic. Each underwent double stenting (LVIS within Enterprise), without coil insertion, using local anesthesia. Conventional angiographic follow-up regularly disclosed excellent saccular occlusion and subsequent remodeling of stented arteries. LVIS-within-Enterprise double stenting may be of particular benefit in patients with VADAs, the Enterprise providing outer support to minimize stent bulging (as a fusiform aneurysm) as the inner LVIS reinforces flow diversion.


2010 ◽  
Vol 19 (5) ◽  
pp. 420-424
Author(s):  
Kenta Aso ◽  
Yoshitaka Kubo ◽  
Shunsuke Kakino ◽  
Hiroshi Kashimura ◽  
Atsushi Sugawara ◽  
...  

2009 ◽  
Vol 15 (3) ◽  
pp. 349-354 ◽  
Author(s):  
T. Hrbáč ◽  
P. Drábek ◽  
P. Klement ◽  
V. Procházka

A fusiform aneurysm in the terminal M1 middle cerebral artery (MCA) segment was treated by a construction of a high-flow arterial extracranial-intracranial (EC-IC) bypass. Due to severe bypass vasospasms, local vasodilating agents together with percutaneous angioplasty and stent implantation were applied, but failed due to subsequent bypass occlusion. To remedy this complication a new bypass was created from a segment of the saphenous vein, followed by MCA aneurysm embolization and parent artery occlusion. One year after the surgery, the venous bypass remains patent and the aneurysm occluded, with the patient fully active, without any neurological sequelae.


2008 ◽  
Vol 14 (2_suppl) ◽  
pp. 75-78 ◽  
Author(s):  
Michael Mu Huo Teng ◽  
Chao-Bao Luo ◽  
Feng-Chi Chang ◽  
Harsan Harsan

Typical treatment of intracranial aneurysm includes: surgical clipping, intrasacular packing, and parent artery occlusion. The treatment of a fusiform aneurysm is often parent artery occlusion, and keeping patency of the parent artery is difficult. We report our experience in the treatment of 3 cases of intracranial fusiform aneurysm with stent placement inside the parent artery only, without coil packing of the aneurysm lumen. All 3 patients had a non-hemorrhagic dissecting aneurysm in the vertebral artery. They were treated with 2 Helistents, 3 Neuroform stents, and 2 Neuroform stents, respectively. These aneurysms disappeared after treatment at their follow-up angiograms. Treatment with a bare stent may induce obliteration or reduction in the size of some aneurysms. This technique is useful in the treatment of non-hemorrhagic fusiform-shaped aneurysms or non-hemorrhagic dissecting aneurysms to preserve the patency of these parent arteries.


Nosotchu ◽  
1985 ◽  
Vol 7 (4) ◽  
pp. 344-350
Author(s):  
Sumio Ohta ◽  
Takenori Yamaguchi ◽  
Jun Ogata ◽  
Mamoru Ito ◽  
Haruhiko Kikuchi

2004 ◽  
Vol 62 (3b) ◽  
pp. 899-902 ◽  
Author(s):  
Adriana Bastos Conforto ◽  
Paulo Puglia Jr ◽  
Fábio Iuji Yamamoto ◽  
Milberto Scaff

We report the case of a 36 year-old woman who presented occlusion of a basilar artery fusiform aneurysm (FA) associated with pontine infarction, and two episodes of subarachnoid hemorrhage possibly due to arterial dissection. She also had asymptomatic FAs in the right middle cerebral and left internal carotid arteries. Over 5 years, lesions suggestive of fibromuscular dysplasia in the right vertebral artery and occlusion of the left vertebral artery were observed. This combination of lesions emphasizes the possibility of a common pathogenetic mechanism causing different degrees of media disruption in cervicocranial arteries.


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