Staged Endovascular Management of a Ruptured Intracranial Aneurysm

Abstract

The goal of treatment of ruptured intracranial aneurysms is the exclusion of the aneurysm from the intracranial circulation.

Recently endovascular techniques have provided an alternative to open surgery in selected patients. Herein, we present a patient who underwent staged endovascular procedures to achieve definitive treatment of an intracranial fusiform vertebral artery aneurysm.

Definitive immediate therapy for the aneurysm was not possible at first presentation because of the aneurysm location and configuration, and because of absence of collateral circulation. The first stage involved coiling a daughter bleb suspected of being the source of haemorrhage.

This provided acute protection against rebleeding without sacrificing the parent artery. The second and more definitive stage, delayed for 31 days, involved balloon occlusion of a fusiform aneurysm by sacrificing the parent vessel.

Keywords

aneurysm staging balloon coil

Get full access to this article

View all access options for this article.

References

Butler

Barker

Crowell

: Patients with Polycystic Kidney disease would benefit from routine magnetic resonance angiographic screening for intracerebral aneurysms: A decision analysis. Neurosurg 38: 506–516, 1996.

Guglielmi

Viñuela

: Endovascular treatment of posterior circulation aneurysms electrothrombosis using electrically detachable coils, J Neurosurg 77: 515–524, 1992.

Säveland

Brandt

: Which are the major determinants for outcome in aneurysm subarachnoid haemorrhage? A prospective total management study from a strictly unsclected series. Acta Neurol Scand 90: 245–250, 1994.

Schievink

Wijdicks

EFM

: The poor prognosis of ruptured intraccranial aneurysms of the posterior circulation. J Neurosurg 82: 791–795, 1995.

Viñuela

Duckwiler

Mawad

: Guglielmi detachable coil embolisation of acute intracranial aneurysm: Perioperative anatomical and clinical outcome in 403 patients. J Neurosurg 86: 475–482, 1997.