scholarly journals Posterior Cerebral Artery Aneurysm Associated with Unilateral Internal Carotid Artery Agenesis

1995 ◽  
Vol 35 (11) ◽  
pp. 825-829 ◽  
Author(s):  
Mitsunobu IDE ◽  
Minoru JIMBO ◽  
Masaaki YAMAMOTO ◽  
Shinji HAGIWARA
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Posterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Cerebral Artery Aneurysm

scholarly journals Internal Carotid Artery to Posterior Cerebral Artery Bypass for Fusiform Basilar Artery Aneurysm: 2-Dimensional Operative Video

2019 ◽  
Vol 18 (1) ◽  
pp. E1-E1
Author(s):  
Benjamin K Hendricks ◽  
Robert F Spetzler
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Posterior Cerebral Artery ◽  
Artery Bypass ◽  
Management Strategies ◽  
Video Recording ◽  
Artery Aneurysm ◽  
Interposition Graft

Abstract Fusiform dolichoectatic basilar trunk aneurysms pose an immense surgical challenge because of the extremely eloquent tissue at risk during the procedure and the complex management strategies required to relieve mass effect on the brainstem. The patient presented in this case experienced progressive brainstem deterioration with quadraparesis and multiple cranial neuropathies. The patient underwent a modified orbitozygomatic craniotomy for visualization, and an end-to-side anastomosis between a radial artery interposition graft and the posterior cerebral artery was performed, followed by an end-to-side anastomosis of the interposition graft to the intracranial internal carotid artery. A permanent clip was applied to the top of the basilar trunk to obliterate distal flow. Postoperative imaging demonstrated progressive thrombosis of the fusiform aneurysm. Basilar aneurysms represent challenging lesions for both microsurgical and endovascular treatments. 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.

Bilateral Internal Carotid to Anterior Cerebral Artery Anastomosis with Anterior Communicating Artery Aneurysm: Technical Case Report

2005 ◽  
Vol 57 (suppl_4) ◽  
pp. ONS-E400-ONS-E400 ◽  
Author(s):  
Kaya Kılıç ◽  
Metin Orakdöğen ◽  
Aram Bakırcı ◽  
Zafer Berkman
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Anterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery

Abstract OBJECTIVE AND IMPORTANCE: The present case report is the first one to report a bilateral anastomotic artery between the internal carotid artery and the anterior communicating artery in the presence of a bilateral A1 segment, fenestrated anterior communicating artery (AComA), and associated aneurysm of the AComA, which was discovered by magnetic resonance angiography and treated surgically. CLINICAL PRESENTATION: A 38-year-old man who was previously in good health experienced a sudden onset of nuchal headache, vomiting, and confusion. Computed tomography revealed a subarachnoid hemorrhage. Magnetic resonance angiography and four-vessel angiography documented an aneurysm of the AComA and two anastomotic vessels of common origin with the ophthalmic artery, between the internal carotid artery and AComA. INTERVENTION: A fenestrated clip, introduced by a left pterional craniotomy, leaving in its loop the left A1 segment, sparing the perforating and hypothalamic arteries, excluded the aneurysm. CONCLUSION: The postoperative course was uneventful, with complete recovery. Follow-up angiograms documented the successful exclusion of the aneurysm. Defining this particular internal carotid-anterior cerebral artery anastomosis as an infraoptic anterior cerebral artery is not appropriate because there is already an A1 segment in its habitual localization. Therefore, it is also thought that, embryologically, this anomaly is not a misplaced A1 segment but the persistence of an embryological vessel such as the variation of the primitive prechiasmatic arterial anastomosis. The favorable outcome for our patient suggests that surgical treatment may be appropriate for many patients with this anomaly because it provides a complete and definitive occlusion of the aneurysm.

Competitive flow diversion of multiple P1 aneurysms: proposed classification

2020 ◽  
Vol 13 (6) ◽  
pp. e015581
Author(s):  
Mark Alexander MacLean ◽  
Thien J Huynh ◽  
Matthias Helge Schmidt ◽  
Vitor M Pereira ◽  
Adrienne Weeks
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Posterior Cerebral Artery ◽  
Flow Diversion ◽  
Endovascular Coiling ◽  
Ruptured Aneurysms ◽  
The Right

We report the case of a patient with subarachnoid hemorrhage and three aneurysms arising from the posterior communicating artery (Pcomm)-P1 complex, treated with endovascular coiling and competitive flow diversion. The largest and likely ruptured Pcomm aneurysm was treated with traditional coiling. Two smaller potentially ruptured aneurysms arose from the distal right posterior cerebral artery (PCA) P1 segment. After a failed attempt to treat with conventional flow diversion across the PCA-P1 segment, the P1 aneurysms were successfully treated with competitive flow diversion distal to the PCA-P1 segment from Pcomm to the P2 segment. Over 12 months, competitive flow diversion redirected flow to the right PCA territory via the internal carotid artery-Pcomm-P2, reducing the size of the PCA-P1 segment and obliterating the P1 aneurysms. Competitive flow diversion treatment should be considered for aneurysms occurring at the circle of Willis when traditional methods are not feasible. Herein, we introduce a novel classification for competitive flow diversion treatment.

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