scholarly journals A large paraclinoid aneurysm treated by preoperative ophthalmic artery embolization followed by high flow bypass and proximal parent artery occlusion: a case report

2013 ◽  
Vol 7 (1) ◽  
pp. 11-17
Author(s):  
Shigenori KATAYAMA ◽  
Keiji KIDOGUCHI ◽  
Naoya TAKEDA
Keyword(s):  
Case Report ◽  
Ophthalmic Artery ◽  
Artery Occlusion ◽  
High Flow ◽  
Parent Artery ◽  
Artery Embolization ◽  
Paraclinoid Aneurysm ◽  
Parent Artery Occlusion

scholarly journals Cerebral revascularization for the management of complex intracranial aneurysms: a single-center experience

2019 ◽  
Vol 131 (4) ◽  
pp. 1297-1307 ◽  
Author(s):  
Eric S. Nussbaum ◽  
Kevin M. Kallmes ◽  
Jeffrey P. Lassig ◽  
James K. Goddard ◽  
Michael T. Madison ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Case Series ◽  
Artery Occlusion ◽  
High Flow ◽  
Cerebral Revascularization ◽  
Low Flow ◽  
Parent Artery ◽  
Team Approach ◽  
Parent Artery Occlusion

OBJECTIVEBecause simple intracranial aneurysms (IAs) are increasingly treated endovascularly, neurovascular surgery has become focused on complex IAs that may require deconstructive aneurysm therapy with concomitant surgical bypass. The authors describe the decision-making process concerning cerebral revascularization and present outcomes that were achieved in a large case series of complex IAs managed with cerebral revascularization and parent artery occlusion.METHODSThe authors retrospectively reviewed the medical records, including neuroimaging studies, operative reports, and follow-up clinic notes, of all patients who were treated at the National Brain Aneurysm Center between July 1997 and June 2015 using cerebral revascularization as part of the management of an IA. They recorded the location, rupture status, and size of each IA, as well as neurological outcome using the modified Rankin Scale (mRS), aneurysm and bypass status at follow-up, and morbidity and mortality.RESULTSThe authors identified 126 patients who underwent revascularization surgery for 126 complex, atheromatous, calcified, or previously coiled aneurysms. Ninety-seven lesions (77.0%) were unruptured, and 99 (78.6%) were located in the anterior circulation. Aneurysm size was giant (≥ 25 mm) in 101 patients, large (10–24 mm) in 9, and small (≤ 9 mm) in 16 patients. Eighty-four low-flow bypasses were performed in 83 patients (65.9%). High-flow bypass was performed in 32 patients (25.4%). Eleven patients (8.7%) underwent in situ or intracranial-intracranial bypasses. Major morbidity (mRS score 4 or 5) occurred in 2 (2.4%) low-flow cases and 3 (9.1%) high-flow cases. Mortality occurred in 2 (2.4%) low-flow cases and 2 (6.1%) high-flow cases. At the 12-month follow-up, 83 (98.8%) low-flow and 30 (93.8%) high-flow bypasses were patent. Seventy-five patients (90.4%) undergoing low-flow and 28 (84.8%) high-flow bypasses had an mRS score ≤ 2. There were no statistically significant differences in patency rates or complications between low- and high-flow bypasses.CONCLUSIONSWhen treating challenging and complex IAs, incorporating revascularization strategies into the surgical repertoire may contribute to achieving favorable outcomes. In our series, low-flow bypass combined with isolated proximal or distal parent artery occlusion was associated with a low rate of ischemic complications while providing good long-term aneurysm control, potentially supporting its wider utilization in this setting. The authors suggest that consideration should be given to managing complex IAs at high-volume centers that offer a multidisciplinary team approach and the full spectrum of surgical and endovascular treatment options to optimize patient outcomes.

scholarly journals Internal carotid artery occlusion may affect long-term quality of life in patients with high-flow carotid cavernous fistulas

2019 ◽  
Vol 26 (1) ◽  
pp. 83-89 ◽  
Author(s):  
Rong-Qin Dai ◽  
Wei-Xing Bai ◽  
Bu-Lang Gao ◽  
Tian-Xiao Li ◽  
Kun Zhang
Keyword(s):  
Quality Of Life ◽  
Artery Occlusion ◽  
High Flow ◽  
Parent Artery ◽  
Parent Artery Occlusion ◽  
Carotid Cavernous Fistulas ◽  
Headache Impact

Purpose To investigate the mid- and long-term effects of parent artery occlusion on the carotid cavernous fistula and on the quality of life of patients. Materials and methods One hundred and twenty-six patients with high-flow direct carotid cavernous fistulas were enrolled. The modified Rankin scale scores, the headache impact test and the short form health survey scores were used to evaluate the patients' clinical status. Results Fifty-two patients had parent artery occlusion, while the rest of the 74 patients had embolization of carotid cavernous fistulas with parent artery preservation. No periprocedural complications occurred. Eighteen patients in the parent artery occlusion group had low perfusion symptoms within two weeks following embolization, and three patients had Horner's syndrome on the ipsilateral side. At two months' follow-up, the patients with parent artery occlusion had a significantly ( P < 0.05) greater proportion of headache than patients with parent artery preservation. At 12 months, no significant ( P > 0.05) difference existed in the headache impact test scores in both groups. At 36 months' follow-up, the patients with parent artery occlusion had decreased SF-30 scores in all the eight health domains compared with patients treated with parent artery preservation, with a significant ( P < 0.05) lower score in general health, vitality and bodily pain in the parent artery occlusion compared with the parent artery preservation group. No recurrence was shown in patients with parent artery occlusion, but nine (12.2%) patients were recurrent in patients with parent artery preservation. Conclusion Parent artery occlusion may affect the quality of life of patients with carotid cavernous fistulas despite being an effective treatment option for high-flow direct fistulas.

Parent Artery Occlusion for Treatment of a Traumatic Pericallosal Artery Aneurysm: Case Report and Review of the Literature

2020 ◽  
Vol 140 ◽  
pp. 193-197
Author(s):  
Yuichiro Tsuji ◽  
Takanori Miki ◽  
Hiroto Kakita ◽  
Kimitoshi Sato ◽  
Takashi Yoshida ◽  
...  
Keyword(s):  
Case Report ◽  
Artery Aneurysm ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Review Of The Literature ◽  
Pericallosal Artery ◽  
Parent Artery Occlusion
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