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Symptomatic Cavernous Internal Carotid Artery Aneurysm Complicated by Simultaneous Rapid Growth of the Intra-aneurysmal and Parent Artery Thromboses
Cavernous internal carotid artery (ICA) aneurysm complicated by simultaneous and spontaneous formation of thromboses in the aneurysm and the parent artery is a rare clinical condition. Although the majority of patients have good outcomes, some patients experience severe ischemic stroke. Here, we rep...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japan Neurosurgical Society
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8769381/ https://www.ncbi.nlm.nih.gov/pubmed/35079460 http://dx.doi.org/10.2176/nmccrj.cr.2020-0090 |
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author | YAMAGAMI, Keitaro HATANO, Taketo ANDO, Mitsushige CHIHARA, Hideo OGURA, Takenori SUZUKI, Keita KONDO, Daisuke KAMATA, Takahiko HIGASHI, Eiji SAKAI, Shota SAKAMOTO, Hiroki NAGATA, Izumi |
author_facet | YAMAGAMI, Keitaro HATANO, Taketo ANDO, Mitsushige CHIHARA, Hideo OGURA, Takenori SUZUKI, Keita KONDO, Daisuke KAMATA, Takahiko HIGASHI, Eiji SAKAI, Shota SAKAMOTO, Hiroki NAGATA, Izumi |
author_sort | YAMAGAMI, Keitaro |
collection | PubMed |
description | Cavernous internal carotid artery (ICA) aneurysm complicated by simultaneous and spontaneous formation of thromboses in the aneurysm and the parent artery is a rare clinical condition. Although the majority of patients have good outcomes, some patients experience severe ischemic stroke. Here, we report a case of symptomatic large cavernous ICA aneurysm complicated by rapid growth of an intra-aneurysmal thrombosis with simultaneous parent artery thrombosis. A 68-year-old female presented with sudden-onset diplopia, right ptosis, right conjunctival hyperemia, and paresthesia of the right face. Magnetic resonance imaging (MRI) and digital subtract angiography (DSA) revealed the presence of a large partially thrombosed aneurysm in the cavernous portion of the right ICA. We planned endovascular embolization using a flow-diverting (FD) stent. Dual-antiplatelet therapy (DAPT) with aspirin and clopidogrel was started 2 weeks prior to treatment. Although the neurological state was stable, DSA conducted on the day of the endovascular treatment showed rapid growth of an intra-aneurysmal thrombosis and de novo thrombosis in the parent artery. Direct aspiration was performed via a distal support catheter with proximal blood flow arrest using a balloon-guide catheter, and the FD stent was successfully deployed. The patient’s symptoms improved postoperatively and DSA obtained 12 months after the procedure confirmed complete occlusion of the aneurysm. Although the exact mechanism of simultaneous thrombosis formation of the aneurysm and its parent artery remains unclear, it is important to recognize that rapid growth of the thrombosis increases the risk of ischemic stroke. |
format | Online Article Text |
id | pubmed-8769381 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Japan Neurosurgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-87693812022-01-24 Symptomatic Cavernous Internal Carotid Artery Aneurysm Complicated by Simultaneous Rapid Growth of the Intra-aneurysmal and Parent Artery Thromboses YAMAGAMI, Keitaro HATANO, Taketo ANDO, Mitsushige CHIHARA, Hideo OGURA, Takenori SUZUKI, Keita KONDO, Daisuke KAMATA, Takahiko HIGASHI, Eiji SAKAI, Shota SAKAMOTO, Hiroki NAGATA, Izumi NMC Case Rep J Case Report Cavernous internal carotid artery (ICA) aneurysm complicated by simultaneous and spontaneous formation of thromboses in the aneurysm and the parent artery is a rare clinical condition. Although the majority of patients have good outcomes, some patients experience severe ischemic stroke. Here, we report a case of symptomatic large cavernous ICA aneurysm complicated by rapid growth of an intra-aneurysmal thrombosis with simultaneous parent artery thrombosis. A 68-year-old female presented with sudden-onset diplopia, right ptosis, right conjunctival hyperemia, and paresthesia of the right face. Magnetic resonance imaging (MRI) and digital subtract angiography (DSA) revealed the presence of a large partially thrombosed aneurysm in the cavernous portion of the right ICA. We planned endovascular embolization using a flow-diverting (FD) stent. Dual-antiplatelet therapy (DAPT) with aspirin and clopidogrel was started 2 weeks prior to treatment. Although the neurological state was stable, DSA conducted on the day of the endovascular treatment showed rapid growth of an intra-aneurysmal thrombosis and de novo thrombosis in the parent artery. Direct aspiration was performed via a distal support catheter with proximal blood flow arrest using a balloon-guide catheter, and the FD stent was successfully deployed. The patient’s symptoms improved postoperatively and DSA obtained 12 months after the procedure confirmed complete occlusion of the aneurysm. Although the exact mechanism of simultaneous thrombosis formation of the aneurysm and its parent artery remains unclear, it is important to recognize that rapid growth of the thrombosis increases the risk of ischemic stroke. The Japan Neurosurgical Society 2021-06-10 /pmc/articles/PMC8769381/ /pubmed/35079460 http://dx.doi.org/10.2176/nmccrj.cr.2020-0090 Text en © 2021 The Japan Neurosurgical Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Case Report YAMAGAMI, Keitaro HATANO, Taketo ANDO, Mitsushige CHIHARA, Hideo OGURA, Takenori SUZUKI, Keita KONDO, Daisuke KAMATA, Takahiko HIGASHI, Eiji SAKAI, Shota SAKAMOTO, Hiroki NAGATA, Izumi Symptomatic Cavernous Internal Carotid Artery Aneurysm Complicated by Simultaneous Rapid Growth of the Intra-aneurysmal and Parent Artery Thromboses |
title | Symptomatic Cavernous Internal Carotid Artery Aneurysm Complicated by Simultaneous Rapid Growth of the Intra-aneurysmal and Parent Artery Thromboses |
title_full | Symptomatic Cavernous Internal Carotid Artery Aneurysm Complicated by Simultaneous Rapid Growth of the Intra-aneurysmal and Parent Artery Thromboses |
title_fullStr | Symptomatic Cavernous Internal Carotid Artery Aneurysm Complicated by Simultaneous Rapid Growth of the Intra-aneurysmal and Parent Artery Thromboses |
title_full_unstemmed | Symptomatic Cavernous Internal Carotid Artery Aneurysm Complicated by Simultaneous Rapid Growth of the Intra-aneurysmal and Parent Artery Thromboses |
title_short | Symptomatic Cavernous Internal Carotid Artery Aneurysm Complicated by Simultaneous Rapid Growth of the Intra-aneurysmal and Parent Artery Thromboses |
title_sort | symptomatic cavernous internal carotid artery aneurysm complicated by simultaneous rapid growth of the intra-aneurysmal and parent artery thromboses |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8769381/ https://www.ncbi.nlm.nih.gov/pubmed/35079460 http://dx.doi.org/10.2176/nmccrj.cr.2020-0090 |
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