A Patient in Whom Straightening of a Parent Vessel Related to Insertion of a Braided Stent Contributed to Complete Occlusion of an Intracranial Aneurysm

Fujii, Takashi; Oishi, Hidenori; Teranishi, Kohsuke; Yatomi, Kenji; Yamamoto, Munetaka

doi:10.5797/jnet.cr.2018-0034

Cited by 1 publication

(1 citation statement)

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“…Stent-assisted coil embolization for cerebral aneurysms has been reported to straighten the parent vessels over time. [1][2][3][4][5][6] However, detailed reports documenting the hemodynamic change in bifurcation-type aneurysms due to straightening of the parent vessel immediately after stent deployment are scarce. In a case of subarachnoid hemorrhage (SAH) due to a ruptured bifurcation-type anterior communicating artery (AComA) aneurysm, we performed craniotomy aneurysm neck clipping.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic Change due to Vessel Straightening Immediately after LVIS Jr. Deployment for an Anterior Communicating Artery Aneurysm

Takada

Ikeda

Kurosaki

et al. 2022

JNET

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Objective Stent-assisted coil embolization for cerebral aneurysms may lead to straightening of the parent vessel. However, detailed reports documenting the hemodynamic change in bifurcation type aneurysms due to straightening of the parent vessel immediately after stent deployment are scarce. Case Presentation A 48-year-old woman with a history of polycystic kidney disease underwent aneurysm neck clipping with left frontotemporal craniotomy for a ruptured bifurcation-type anterior communicating artery (AComA) aneurysm. Angiography 18 days after clipping showed a recurrent AComA aneurysm, for which stent-assisted coil embolization was performed. Straightening of the parent vessel immediately after deployment of a low-profile visualized intraluminal support junior (LVIS Jr.) stent from the AComA to the A1 segment of the right anterior cerebral artery was confirmed by working projection angiography. The aneurysm was easily embolized with coils with the support of the stent covering the aneurysm neck. The embolization was finished with a slight dome filling of the aneurysm. The parent vessel angle in 3D angiography changed from 90° before stent deployment to 160° immediately after stent deployment. Angiography 2 months after embolization showed the aneurysm with a complete occlusion and the parent vessel angle of 170° in a 3D image. Conclusion The hemodynamic change in a bifurcation-type AComA aneurysm due to straightening of the parent vessel immediately after the LVIS Jr. stent deployment led to the covering of the aneurysm neck, resulting in good coil embolization, to which the vessel mobility and the stenting method may have contributed.

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