Fusiform "True" Posterior Communicating Artery Aneurysm with Basilar Artery Occlusion: A Case Report.

IF 1.2 Q4 CLINICAL NEUROLOGY
Neurointervention Pub Date : 2024-03-01 Epub Date: 2024-02-16 DOI:10.5469/neuroint.2023.00472
Ritu Shah, Rashmi Saraf
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引用次数: 0

Abstract

Isolated posterior communicating artery (PCoA) aneurysms are rare, predominantly fusiform in morphology, and rarely present with subarachnoid hemorrhage. Endovascular management of this pathology is technically challenging due to extreme tortuosity, the artery course in the subarachnoid space, sharp angulations at PCoA junctions with the parent artery, and, at times, associations with either internal carotid artery or basilar artery occlusions. We present a case of a ruptured fusiform PCoA at the junction of middle and distal third with concomitant proximal basilar artery occlusion. The PCoA reforms the posterior circulation, making it a vital artery. Stent-assisted coiling was performed with extreme difficulty in achieving distal positioning of the stents in the basilar artery/posterior cerebral artery/distal PCoA due to artery tortuosity. There was technical difficulty in the stent deployment. After changing strategies to a larger diameter laser-cut stent, endovascular treatment could be performed. There were good angiographic and clinical outcomes with stable occlusion at 6-month-follow-up.

纺锤形 "真 "后交通动脉瘤伴基底动脉闭塞:病例报告。
孤立性后交通动脉瘤(PCoA)非常罕见,形态主要为纺锤形,很少伴有蛛网膜下腔出血。由于动脉极度迂曲、动脉在蛛网膜下腔的走向、PCoA 与母动脉交界处的锐角,以及有时与颈内动脉或基底动脉闭塞有关,这种病变的血管内治疗在技术上具有挑战性。我们介绍了一例在中段和远端三分之一交界处的纺锤形 PCoA 破裂并同时伴有近端基底动脉闭塞的病例。PCoA 改变了后循环,使其成为一条重要动脉。由于动脉迂曲,在基底动脉/大脑后动脉/远端 PCoA 中进行支架辅助卷绕时,支架远端定位极为困难。支架植入也存在技术困难。在改用直径更大的激光切割支架后,血管内治疗得以进行。随访6个月后,血管造影和临床效果良好,闭塞情况稳定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
34
审稿时长
12 weeks
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