scholarly journals Provocative Testing Prior to Anterior Cerebral Artery Fusiform Aneurysm Embolization

2017 ◽  
Vol 7 (1-2) ◽  
pp. 36-41
Author(s):  
Pouria Moshayedi ◽  
Dan-Victor Giurgiutiu ◽  
Andrew F. Ducruet ◽  
Brian T. Jankowitz ◽  
Ashutosh P. Jadhav
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Parent Artery ◽  
Fusiform Aneurysm ◽  
Balloon Test Occlusion ◽  
First Case ◽  
Parent Artery Occlusion ◽  
Aneurysm Embolization ◽  
Provocative Testing ◽  
Sodium Amobarbital

We report 2 cases of parent artery occlusion (PAO) for anterior cerebral artery (ACA) fusiform aneurysm embolization after superselective provocative testing was performed to confirm distal territory viability. The first case involves a patient in the second decade of life who presented with subarachnoid hemorrhage and underwent PAO after a balloon test occlusion in the distal ACA revealed no neurophysiology changes. The second case involves another patient in the forth decade of life who presented with an enlarging pseudoaneurysm and underwent PAO after a sodium amobarbital infusion in the distal ACA revealed no clinical change. Both patients tolerated PAO without clinical compromise. PAO after provocative testing may be a safe and effective strategy in the management of fusiform aneurysm treatment. Key Messages: Provocative testing with superselective balloon test occlusion and sodium amobarbital infusion are both viable options for clinical and physiological interrogation of brain tissue prior to parent vessel occlusion. Neurophysiological monitoring may be a useful surrogate for clinical examination after provocative testing, particularly if patients were treated under general anesthesia.

scholarly journals A Combined Approach to Treatment of the Dissecting Middle Cerebral Artery Fusiform Aneurysm

2009 ◽  
Vol 15 (3) ◽  
pp. 349-354 ◽  
Author(s):  
T. Hrbáč ◽  
P. Drábek ◽  
P. Klement ◽  
V. Procházka
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Fusiform Aneurysm ◽  
Neurological Sequelae ◽  
Parent Artery Occlusion ◽  
Aneurysm Embolization ◽  
Mca Aneurysm ◽  
One Year

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.

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 Parent Artery Occlusion for Posterior Cerebral Artery Aneurysms

2006 ◽  
Vol 12 (1_suppl) ◽  
pp. 125-128 ◽  
Author(s):  
K. Hoya ◽  
M. Nagaishi ◽  
Y. Yoshimoto ◽  
E. Morikawa ◽  
H. Takahashi
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Balloon Test Occlusion ◽  
Parent Artery Occlusion ◽  
Permanent Occlusion

We review four cases of posterior cerebral artery (PCA) aneurysm, of which three showed intolerance of parent artery occlusion. In two, balloon test occlusion (BTO) indicated poor opacification of the PCA branches from the anastomoses, and therefore, permanent occlusion was not attempted.

Left A2 Fusiform Aneurysm: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (2) ◽  
pp. E142-E142 ◽  
Author(s):  
Benjamin K Hendricks ◽  
Robert F Spetzler
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Video Recording ◽  
Parent Artery ◽  
Fusiform Aneurysm ◽  
Bypass Procedure ◽  
Institutional Review ◽  
Interhemispheric Fissure ◽  
Aneurysm Thrombosis ◽  
Wide Neck

Abstract Anterior cerebral artery aneurysms within the A2 segment that are fusiform or giant A2 aneurysms with a wide neck often are not candidates for endovascular treatment and require surgical intervention. These lesions necessitate a bypass procedure to preserve distal flow along the anterior cerebral artery. This patient demonstrated a left-sided unruptured A2 fusiform aneurysm that necessitated a bypass procedure for management. The patient was positioned with the head rotated laterally to permit orientation of the interhemispheric fissure within the horizontal plane and achieve gravity retraction of the dependent hemisphere. The bilateral pericallosal branches were exposed and liberated from arachnoid adhesions to permit mobilization necessary for the side-to-side anastomosis. While the anastomosis was performed, the continuous suture loops were left loose to permit complete visualization of the inner and outer walls prior to the final tightening and tying of the anastomotic suture. Following the completion of the anastomosis, the temporary clips were removed. A permanent clip was placed on the distal A2 to prevent outflow from the parent artery and thereby allow for aneurysm thrombosis. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

scholarly journals Dissecting Aneurysm at the Proximal Anterior Cerebral Artery Treated by Parent Artery Occlusion

2009 ◽  
Vol 15 (1) ◽  
pp. 123-126 ◽  
Author(s):  
M. Lv ◽  
X. Lv ◽  
Y. Li ◽  
C. Jiang ◽  
P. Jiang ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Artery Occlusion ◽  
Dissecting Aneurysm ◽  
Parent Artery ◽  
Parent Artery Occlusion ◽  
Proximal Anterior Cerebral Artery ◽  
Neuroform Stent

Aneurysms of the A1 segment of the anterior cerebral artery (ACA) are rare. We described the first documented endovascular treatment of an A1 portion dissecting aneurysm by parent artery occlusion. A 43-year-old man patient presented with subarachnoid hemorrhage. Cerebral angiography demonstrated a dissecting aneurysm of the left anterior cerebral artery (ACA) at A1 portion. Because of the dissecting nature of the A1 portion aneurysm, a 2.5×15-mm Neuroform stent was placed in the left A1 portion. However, regrowth of the aneurysm was found on the three month follow-up angiogram, so the aneurysm and the left A1 portion of ACA were occluded completely.

Republished: Successful treatment of ruptured multiple fusiform middle cerebral artery aneurysms with silk vista baby flow diverter in a 10-months-old infant

2021 ◽  
pp. neurintsurg-2021-017554.rep
Author(s):  
Giovanni Barchetti ◽  
Loris Di Clemente ◽  
Mauro Mazzetto ◽  
Mariano Zanusso ◽  
Paola Ferrarese ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Successful Treatment ◽  
Expectant Management ◽  
Flow Diverter ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Microsurgical Clipping ◽  
Parent Artery Occlusion ◽  
The Right

We report the successful treatment of multiple ruptured fusiform middle cerebral artery (MCA) aneurysms in a 10-month-old girl. This previously healthy infant presented with subarachnoid haemorrhage and was found to have multiple irregular dilatations of the superior division branch of the right MCA. Cerebral angiography was performed and confirmed the presence of multiple fusiform aneurysms of the MCA. After multidisciplinary team discussion, it was decided to treat the aneurysms with endovascular approach, using a flow-diverter. Microsurgical clipping was deemed risky because of the high likelihood of parent artery occlusion and expectant management was also considered inappropriate because of the risk of re-bleeding. Dual antiplatelet therapy was started, and a flow-diverter was successfully delivered in the superior division branch of the right MCA. The post-operative course was uneventful, MRI at 12 months did not show any sign of recurrence and at 3 years of age the patient had a normal neurological examination.

scholarly journals Treatment of Intracranial Aneurysm with Bare Stent Only

2008 ◽  
Vol 14 (2_suppl) ◽  
pp. 75-78 ◽  
Author(s):  
Michael Mu Huo Teng ◽  
Chao-Bao Luo ◽  
Feng-Chi Chang ◽  
Harsan Harsan
Keyword(s):  
Intracranial Aneurysm ◽  
Artery Occlusion ◽  
Dissecting Aneurysm ◽  
Parent Artery ◽  
Fusiform Aneurysm ◽  
Surgical Clipping ◽  
Parent Artery Occlusion ◽  
Typical Treatment ◽  
Dissecting Aneurysms

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.

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