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Trapping and A4-A4 end-to-side anastomosis for the treatment of a ruptured A3 fusiform aneurysm: Potential risk of in-situ bypass

The treatment of complicated anterior cerebral artery aneurysms remains challenging. Here, the authors describe a case of ruptured complicated A3 aneurysm, which was treated with trapping and in-situ bypass. A 47-year-old man presented to the emergency department with severe headache and vomiting. C...

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Detalles Bibliográficos
Autores principales: Kim, Young Rak, Lee, Sung Ho, Bae, Jin Woo, Choi, Young Hoon, Ha, Eun Jin, Kim, Kang Min, Cho, Won-Sang, Kang, Hyun-Seung, Kim, Jeong Eun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Cerebrovascular Surgeons and Korean NeuroEndovascular Society 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10073768/
https://www.ncbi.nlm.nih.gov/pubmed/35989080
http://dx.doi.org/10.7461/jcen.2022.E2022.01.003
Descripción
Sumario:The treatment of complicated anterior cerebral artery aneurysms remains challenging. Here, the authors describe a case of ruptured complicated A3 aneurysm, which was treated with trapping and in-situ bypass. A 47-year-old man presented to the emergency department with severe headache and vomiting. Computed tomography illustrated acute intracerebral hemorrhage in the right frontal lobe. Digital subtraction angiography (DSA) confirmed a ruptured fusiform A3 aneurysm with lobulation and a daughter sac. Trapping of the ruptured fusiform A3 aneurysm and distal end-toside A4 anastomosis was performed. DSA on postoperative day 7 showed mild vasospasm to the afferent artery. However, 2 months later, DSA demonstrated that the antegrade flow through the anastomosis site had recovered. Thus, surgeons should be aware of the possibility of postsurgical vasospasm of anastomosed arteries, especially in cases of ruptured aneurysms.