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Unruptured Aneurysmal Shrinkage of the Distal Posterior Inferior Cerebellar Artery Following Stent Jailing of the Arterial Orifice: A Case Report

A 57-year-old woman who presented with a sudden severe headache and subsequently diagnosed with a subarachnoid hemorrhage was referred to our hospital. CTA revealed a large irregularly shaped dissecting aneurysm of the right vertebral artery (VA) and a small round distal aneurysm of the right poster...

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Autores principales: TONE, Osamu, SATO, Yohei, KUBOTA, Yoshihiro, TAKADA, Yoshiaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8769393/
https://www.ncbi.nlm.nih.gov/pubmed/35079530
http://dx.doi.org/10.2176/nmccrj.cr.2021-0090
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author TONE, Osamu
SATO, Yohei
KUBOTA, Yoshihiro
TAKADA, Yoshiaki
author_facet TONE, Osamu
SATO, Yohei
KUBOTA, Yoshihiro
TAKADA, Yoshiaki
author_sort TONE, Osamu
collection PubMed
description A 57-year-old woman who presented with a sudden severe headache and subsequently diagnosed with a subarachnoid hemorrhage was referred to our hospital. CTA revealed a large irregularly shaped dissecting aneurysm of the right vertebral artery (VA) and a small round distal aneurysm of the right posterior inferior cerebellar artery (PICA), which originated just proximal to the VA aneurysm. We diagnosed the VA aneurysm as a ruptured aneurysm and performed endovascular treatment the day the patient was hospitalized. Because the left VA was aplastic, stent-assisted coiling was performed to preserve the blood flow of the right VA, following the administration of antiplatelets and heparin. The proximal part of the laser-cut closed-cell stent jailed the orifice of the right PICA. The postoperative course was uneventful, and she was discharged from the hospital 3 weeks later without any neurological deficits. The follow-up VA angiogram revealed complete disappearance of the distal PICA aneurysm 17 months after stent jailing. Flow reduction by stent jailing of the arterial orifice is considered to be the main mechanism of aneurysmal shrinkage. Jailing of the orifice of the cerebral artery using even a low-metal-coverage stent may cause arterial flow reduction, which may shrink a distal aneurysm.
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spelling pubmed-87693932022-01-24 Unruptured Aneurysmal Shrinkage of the Distal Posterior Inferior Cerebellar Artery Following Stent Jailing of the Arterial Orifice: A Case Report TONE, Osamu SATO, Yohei KUBOTA, Yoshihiro TAKADA, Yoshiaki NMC Case Rep J Case Report A 57-year-old woman who presented with a sudden severe headache and subsequently diagnosed with a subarachnoid hemorrhage was referred to our hospital. CTA revealed a large irregularly shaped dissecting aneurysm of the right vertebral artery (VA) and a small round distal aneurysm of the right posterior inferior cerebellar artery (PICA), which originated just proximal to the VA aneurysm. We diagnosed the VA aneurysm as a ruptured aneurysm and performed endovascular treatment the day the patient was hospitalized. Because the left VA was aplastic, stent-assisted coiling was performed to preserve the blood flow of the right VA, following the administration of antiplatelets and heparin. The proximal part of the laser-cut closed-cell stent jailed the orifice of the right PICA. The postoperative course was uneventful, and she was discharged from the hospital 3 weeks later without any neurological deficits. The follow-up VA angiogram revealed complete disappearance of the distal PICA aneurysm 17 months after stent jailing. Flow reduction by stent jailing of the arterial orifice is considered to be the main mechanism of aneurysmal shrinkage. Jailing of the orifice of the cerebral artery using even a low-metal-coverage stent may cause arterial flow reduction, which may shrink a distal aneurysm. The Japan Neurosurgical Society 2021-10-07 /pmc/articles/PMC8769393/ /pubmed/35079530 http://dx.doi.org/10.2176/nmccrj.cr.2021-0090 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
TONE, Osamu
SATO, Yohei
KUBOTA, Yoshihiro
TAKADA, Yoshiaki
Unruptured Aneurysmal Shrinkage of the Distal Posterior Inferior Cerebellar Artery Following Stent Jailing of the Arterial Orifice: A Case Report
title Unruptured Aneurysmal Shrinkage of the Distal Posterior Inferior Cerebellar Artery Following Stent Jailing of the Arterial Orifice: A Case Report
title_full Unruptured Aneurysmal Shrinkage of the Distal Posterior Inferior Cerebellar Artery Following Stent Jailing of the Arterial Orifice: A Case Report
title_fullStr Unruptured Aneurysmal Shrinkage of the Distal Posterior Inferior Cerebellar Artery Following Stent Jailing of the Arterial Orifice: A Case Report
title_full_unstemmed Unruptured Aneurysmal Shrinkage of the Distal Posterior Inferior Cerebellar Artery Following Stent Jailing of the Arterial Orifice: A Case Report
title_short Unruptured Aneurysmal Shrinkage of the Distal Posterior Inferior Cerebellar Artery Following Stent Jailing of the Arterial Orifice: A Case Report
title_sort unruptured aneurysmal shrinkage of the distal posterior inferior cerebellar artery following stent jailing of the arterial orifice: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8769393/
https://www.ncbi.nlm.nih.gov/pubmed/35079530
http://dx.doi.org/10.2176/nmccrj.cr.2021-0090
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