The Use of a Pipeline Embolization Device for Treatment of a Ruptured Dissecting Middle Cerebral Artery M3/M4 Aneurysm: Challenges and Technical Considerations

Neurointervention

卷:17

Madeline C. Hoover¹  Robert P. Berwanger¹  John A. Scott²  Daniel H. Sahlein²  Krishna Amuluru²  Andrew J. DeNardo²  Troy D. Payner²  Charles G. Kulwin² 

[1] Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, IN, USA;

[2] Division of Interventional Neuroradiology, Goodman Campbell Brain and Spine at Ascension St. Vincent Hospital, Carmel, IN, USA;

关键词: pseudoaneurysm;    subarachnoid hemorrhage;    embolization, therapeutic;    middle cerebral artery;   

DOI  :  10.5469/neuroint.2022.00045

来源: DOAJ

【 摘 要 】

Prompt, effective treatment is necessary following aneurysmal subarachnoid hemorrhage to prevent recurrent rupture, which is thought to double mortality. Atypical ruptured aneurysms, such as blister or dissecting pseudoaneurysms, or those that are unusually distal in the middle cerebral artery (MCA) are challenging to treat with either open or endovascular options, though the pipeline embolization device (PED) has shown promise in multiple case series. We present a case of a ruptured dissecting pseudoaneurysm in the distal MCA (distal M3/proximal M4) prefrontal division in an healthy young patient (<60 years) successfully treated with a PED. The PED was chosen both as the only vessel sparing option in the young patient as well as for its potential as a vessel sacrifice tool if the pseudoaneurysm was felt to be incompletely treated, which in this case was not necessary—though would have leveraged the thrombogenicity of the device as a therapeutic advantage.

【 授权许可】

Unknown