Sage Journals: Discover world-class research

Abstract

We describe three cases of technical failure in patients with giant supraclinoid aneurysm treated with internal carotid artery (ICA) occlusion.

Case 1 was a 65-year-old woman who presented with a two-month history of headache accompanied by blurred vision of the left eye. Case 2 was a 43-year-old woman who presented with a six-month history of headache accompanied by blurred vision of the right eye. Case 3 was a 21-year-old man admitted due to headache and blurred vision of the left eye, accompanied by left oculomotor nerve palsy for three months. Cerebral angiography revealed giant supraclinoid aneurysms in these patients. All of them were treated with ICA occlusion.

One case had recurrent headache symptoms after the first procedure and was retreated. Two cases suffered from post-procedural intracranial hemorrhagic complications.

Before ICA occlusion for giant supraclinoid aneurysm, balloon occlusion test was used to evaluate the collateral anastomosis between the external carotid artery (ECA) and the ICA, and still plays an important role in preventing treatment failure.

Keywords

internal carotid artery aneurysm parent artery occlusion balloon occlusion test collateral anastomosis

Get full access to this article

View all access options for this article.

References

Clarençon

Bonneville

Boch

. Parent artery occlusion is not obsolete in giant aneurysms of the ICA. Experience with very-long-term follow-up. Neuroradiology. 2011; 53 (12): 973–982. doi: 10.1007/s00234-010-0800-8.

. Endovascular management for bilateral ophthalmic segment “kissing aneurysms” presenting with nasal bleeding: case report. Neuroradiol J. 2008; 21 (2): 266–269.

Van der schaaf

Brilstra

Buskens

. Endovascular treatment of aneurysms in the cavernous sinus: a systematic review on balloon occlusion of the parent vessel and embolization with coils. Stroke. 2002; 33 (1): 313–318. doi: 10.1161/hs0102.101479.

Yasui

Yagura

Nagata

. Ischemic complications following parent artery occlusion with detachable balloons in the treatment of large carotid aneurysms: effectiveness of 99m Tc-HMPAO SPECT and importance of postoperative management. No Shinkei Geka. 1992; 20 (11): 1173–1178.

Zhu

Tian

Zhou

. Treatment strategies for complex internal carotid artery (ICA) aneurysms: direct ICA sacrifice or combined with extracranial-to-intracranial bypass. World Neurosurg. 2011; 75 (3–4): 476–484. doi: 10.1016/j.wneu.2010.07.043.

Kadkhodayan

Rhodes

Blackbum

. Comparison of Enterprise with Neuroform stent-assisted coiling of intracranial aneurysms. Am J Roentgenol. 2013; 200 (4): 872–878. doi: 10.2214/AJR.12.8954.

Spiotta

Hui

Moskowitz

. Trends in device-assisted aneurysm treatment at a single high-volume tertiary care center. J Neurointerv surg. 2013; 5 (2): 117–120. doi: 10.1136/neurintsurg-2012-010258.

Maimon

Gonen

Nossek

. Treatment of intra-cranial aneurysms with the SILK flow diverter: 2 years' experience with 28 patients at a single center. Acta Neurochir (Wien). 2012; 154 (6): 979–987. doi: 10.1007/s00701-012-1316-2.

Szikora

Marosfoi

Salomvary

. Resolution of mass effect and compression symptoms following endoluminal flow diversion for the treatment of intracranial aneurysm. Am J Neuroradiol. 2013; 34 (5): 935–939. doi: 10.3174/ajnr.A3547.

10.

Castro

Putman

Sheridan

. Hemodynamic patterns of anterior communicating artery aneurysms: a possible association with rupture. Am J Neuroradiol. 2009; 30 (2): 297–302. doi: 10.3174/ajnr.A1323.

11.

Cebral

Castro

Burgess

. Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models. Am J Neuroradiol. 2005; 26 (10): 2550–2559.

Technical Failure of Giant Supraclinoid Aneurysm after Internal Carotid Artery Occlusion

Abstract

Keywords

Get full access to this article

References