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Outflow occlusion with A3–A3 anastomosis for a doughnut-shaped partially thrombosed giant A2 aneurysm

BACKGROUND: A doughnut-shaped aneurysm, which is defined as a round-shaped aneurysm composed of an intraluminar thrombus and marginal parent artery, is an extremely uncommon subtype of partially thrombosed giant aneurysms. Surgical treatment of this characteristic aneurysm is technically challenging...

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Autores principales: Ito, Hidemichi, Miyano, Ryotaro, Sase, Taigen, Wakui, Daisuke, Matsumori, Takashi, Takasuna, Hiroshi, Oshio, Kotaro, Tanaka, Yuichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5234299/
https://www.ncbi.nlm.nih.gov/pubmed/28144486
http://dx.doi.org/10.4103/2152-7806.196379
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author Ito, Hidemichi
Miyano, Ryotaro
Sase, Taigen
Wakui, Daisuke
Matsumori, Takashi
Takasuna, Hiroshi
Oshio, Kotaro
Tanaka, Yuichiro
author_facet Ito, Hidemichi
Miyano, Ryotaro
Sase, Taigen
Wakui, Daisuke
Matsumori, Takashi
Takasuna, Hiroshi
Oshio, Kotaro
Tanaka, Yuichiro
author_sort Ito, Hidemichi
collection PubMed
description BACKGROUND: A doughnut-shaped aneurysm, which is defined as a round-shaped aneurysm composed of an intraluminar thrombus and marginal parent artery, is an extremely uncommon subtype of partially thrombosed giant aneurysms. Surgical treatment of this characteristic aneurysm is technically challenging. CASE DESCRIPTION: We report a rare case of a 79-year-old man with a symptomatic doughnut-shaped giant aneurysm at the A2 portion, which was successfully treated by outflow occlusion with an A3–A3 side-to-side anastomosis. Postoperative angiograms demonstrated no filling of the doughnut-shaped aneurysm and perfusion in the distal right anterior cerebral artery territory via the anastomosis. Follow-up magnetic resonance imaging 1 year after the surgery demonstrated significant diminution of the aneurysm. CONCLUSIONS: Outflow occlusion with distal revascularization could be an effective surgical option for such a unique aneurysm. To the best of our knowledge, this is the first report of outflow occlusion as a therapy for doughnut-shaped aneurysms.
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spelling pubmed-52342992017-01-31 Outflow occlusion with A3–A3 anastomosis for a doughnut-shaped partially thrombosed giant A2 aneurysm Ito, Hidemichi Miyano, Ryotaro Sase, Taigen Wakui, Daisuke Matsumori, Takashi Takasuna, Hiroshi Oshio, Kotaro Tanaka, Yuichiro Surg Neurol Int Case Report BACKGROUND: A doughnut-shaped aneurysm, which is defined as a round-shaped aneurysm composed of an intraluminar thrombus and marginal parent artery, is an extremely uncommon subtype of partially thrombosed giant aneurysms. Surgical treatment of this characteristic aneurysm is technically challenging. CASE DESCRIPTION: We report a rare case of a 79-year-old man with a symptomatic doughnut-shaped giant aneurysm at the A2 portion, which was successfully treated by outflow occlusion with an A3–A3 side-to-side anastomosis. Postoperative angiograms demonstrated no filling of the doughnut-shaped aneurysm and perfusion in the distal right anterior cerebral artery territory via the anastomosis. Follow-up magnetic resonance imaging 1 year after the surgery demonstrated significant diminution of the aneurysm. CONCLUSIONS: Outflow occlusion with distal revascularization could be an effective surgical option for such a unique aneurysm. To the best of our knowledge, this is the first report of outflow occlusion as a therapy for doughnut-shaped aneurysms. Medknow Publications & Media Pvt Ltd 2016-12-21 /pmc/articles/PMC5234299/ /pubmed/28144486 http://dx.doi.org/10.4103/2152-7806.196379 Text en Copyright: © 2016 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Ito, Hidemichi
Miyano, Ryotaro
Sase, Taigen
Wakui, Daisuke
Matsumori, Takashi
Takasuna, Hiroshi
Oshio, Kotaro
Tanaka, Yuichiro
Outflow occlusion with A3–A3 anastomosis for a doughnut-shaped partially thrombosed giant A2 aneurysm
title Outflow occlusion with A3–A3 anastomosis for a doughnut-shaped partially thrombosed giant A2 aneurysm
title_full Outflow occlusion with A3–A3 anastomosis for a doughnut-shaped partially thrombosed giant A2 aneurysm
title_fullStr Outflow occlusion with A3–A3 anastomosis for a doughnut-shaped partially thrombosed giant A2 aneurysm
title_full_unstemmed Outflow occlusion with A3–A3 anastomosis for a doughnut-shaped partially thrombosed giant A2 aneurysm
title_short Outflow occlusion with A3–A3 anastomosis for a doughnut-shaped partially thrombosed giant A2 aneurysm
title_sort outflow occlusion with a3–a3 anastomosis for a doughnut-shaped partially thrombosed giant a2 aneurysm
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5234299/
https://www.ncbi.nlm.nih.gov/pubmed/28144486
http://dx.doi.org/10.4103/2152-7806.196379
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