Onyx embolization of a ruptured aneurysm in a patient with moyamoya disease

Daou, Badih; Chalouhi, Nohra; Tjoumakaris, Stavropoula; Rosenwasser, Robert H.; Jabbour, Pascal

doi:10.1016/j.jocn.2015.05.017

Cited by 7 publications

(1 citation statement)

References 12 publications

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“…In this study, among 11 aneurysms, PAO by coiling was performed in only 63.6% of cases. For other cases, a thin and soft microcatheter had to be chosen to cast the liquid embolic material, and even if away from the aneurysm, liquid embolic material can occlude the parent artery or penetrate the aneurysm by forward movement ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

Parent artery occlusion for ruptured aneurysms in moyamoya vessels or on collaterals

Zhou

2023

Front. Neurol.

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BackgroundAneurysms in moyamoya vessels or on collaterals are difficult to treat. Parent artery occlusion (PAO) via endovascular treatment (EVT) is often the last resort, but the safety and efficacy of this approach need to be evaluated.Materials and methodsA retrospective study was performed on patients admitted to our hospital who were diagnosed with unilateral or bilateral moyamoya disease (MMD) associated with ruptured aneurysms in moyamoya vessels or on collaterals. These aneurysms were treated with PAO, and the clinical outcome was recorded.ResultsEleven patients were aged 54.7 ± 10.4 years, and six patients were male (54.5%, 6/11). The aneurysms in 11 patients were single and ruptured, and the average size was 2.7 ± 0.6 mm. Three (27.3%, 3/11) aneurysms were located at the distal anterior choroidal artery, 3 (27.3%, 3/11) were at the distal lenticulostriate artery, 3 (27.3%, 3/11) were at the P2–3 segment of the posterior cerebral artery, 1 (9.1%, 1/11) was at the P4–5 segment of the posterior cerebral artery, and 1 was at the transdural location of the middle meningeal artery. Among the 11 aneurysms, PAO by coiling was performed on 7 (63.6%, 7/11), and Onyx casting was performed on 4 (36.4%, 4/11). Of 11 patients, 2 (18.2%, 2/11) suffered intraoperative hemorrhagic complications. During follow-up, all patients had good outcomes with a modified Rankin scale score of 0–2.ConclusionAs a last resort, the application of PAO with coiling or casting Onyx for ruptured aneurysms in moyamoya vessels or on collaterals may be safe with an acceptable clinical outcome. However, patients with MMD may not always achieve expected health outcomes, and PAO for the aneurysm can bring only temporary relief.

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Section: Discussionmentioning

confidence: 99%