Flow alteration surgery using a radial artery graft for recurrent ruptured vertebral artery dissecting aneurysm after stent-assisted coil embolization: A case report

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY Neurochirurgie Pub Date : 2024-06-08 DOI:10.1016/j.neuchi.2024.101574

Masaru Abiko , Yukishige Hashimoto , Masakazu Mitsunobu , Nobutaka Horie

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Abstract

Background

Ruptured vertebral artery dissecting aneurysm (VADA) is often treated surgically with coil embolization and sometimes recurs. We herein report a case of recurrent ruptured VADA after stent-assisted coil embolization (SAC) that was successfully treated with flow alteration surgery using a radial artery (RA) graft.

Case Description

A 67-year-old woman presented with headache and coma. Enhanced CT revealed subarachnoid hemorrhage due to right VADA. Since the left VA was hypoplastic, the aneurysm was treated with SAC. However, follow-up angiography revealed recurrence of the aneurysm. Additional embolization was not considered due to the small size of the recurrent lesion and the presence of a stent; therefore, flow alteration surgery was performed using a RA graft. There were no neurological deficits after surgery or recurrence.

Conclusion

Flow alteration surgery using a RA graft is useful for recurrent VADA after SAC.

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使用桡动脉移植物进行血流改变手术，治疗支架辅助线圈栓塞术后复发的椎动脉剥脱动脉瘤：病例报告

背景破裂的椎动脉剥脱性动脉瘤（VADA）通常采用线圈栓塞术进行手术治疗，但有时会复发。我们在此报告了一例支架辅助线圈栓塞术（SAC）后复发的椎动脉夹层动脉瘤，通过使用桡动脉（RA）移植物进行血流改变手术成功治疗了该患者。增强 CT 显示右侧 VADA 导致蛛网膜下腔出血。由于左侧 VA 发育不良，因此用 SAC 治疗了动脉瘤。然而，随访血管造影显示动脉瘤复发。由于复发病灶较小，且存在支架，因此没有考虑进行额外的栓塞治疗；因此，使用 RA 移植进行了血流改变手术。结论使用 RA 移植物进行血流改变手术对 SAC 后复发的 VADA 很有用。

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.