Treatment of ruptured subclavian steal flow-related vertebrobasilar junction aneurysms: Case report on surgical and endovascular considerations from two cases

INTRODUCTION: Subclavian steal phenomenon causes retrograde flow through the vertebral artery, ipsilateral to the affected subclavian artery, which rarely leads to flow-related vertebrobasilar junction (VBJ) aneurysms. CASE DESCRIPTIONS: We describe two cases of subarachnoid hemorrhage from such rup...

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Detalles Bibliográficos
Autores principales: Cornelissen, Sandra Adriana, Heye, Sam, Maleux, Geert, Daenens, Kim, van Loon, Johannes, De Vleeschouwer, Steven
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741505/
https://www.ncbi.nlm.nih.gov/pubmed/34991048
http://dx.doi.org/10.1016/j.ijscr.2021.106744
Descripción
Sumario:INTRODUCTION: Subclavian steal phenomenon causes retrograde flow through the vertebral artery, ipsilateral to the affected subclavian artery, which rarely leads to flow-related vertebrobasilar junction (VBJ) aneurysms. CASE DESCRIPTIONS: We describe two cases of subarachnoid hemorrhage from such ruptured aneurysms in which the retrograde flow direction in the vertebral artery complicated surgical and endovascular treatment. DISCUSSION: Reversed flow in the vertebral artery, ipsilateral to the stenotic subclavian artery leads to a lack of proximal control in surgical clipping of these VBJ aneurysms and jeopardizes stability of coil and stent placement in endovascular aneurysm treatments in this setting. Conclusion: From these 2 experiences over 7 years, treatment considerations emerged for future cases.

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