Fenestration of a Supraclinoid Internal Carotid Artery Associated With Dual Aneurysms: Case Report
Fenestration of a Supraclinoid Internal Carotid Artery Associated With Dual Aneurysms: Case Report
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DOI：
10.1227/neu.0b013e318223b613
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发表时间：
2011-10-01
期刊：
影响因子：
4.8
通讯作者：
Koketsu, Naoki
中科院分区：
文献类型：
--
作者：
Ichikawa, Tsuyoshi;Miyachi, Shigeru;Koketsu, Naoki
背景和重要性：我们报告了一例罕见的左侧床突上颅内颈内动脉开窗病例，有2个相关动脉瘤从开窗近端和远端出现，并通过血管内弹簧圈栓塞成功治疗。这是第一次报告这些类型的动脉瘤治疗弹簧圈单独。临床表现：一个47岁的女性进行了诊断检查;磁共振血管造影偶然发现2串联动脉瘤在床突上和床突旁的部分，左颈内动脉。血管造影显示左侧颈内动脉床突上开窗，开窗近端和远端各有2个动脉瘤。患者同时接受动脉瘤血管内弹簧圈栓塞术。有意闭塞较小的主干，以实现近端动脉瘤的完全填塞。两个动脉瘤完全闭塞，并没有神经功能缺损的patient.CONCLUSION：根据以往的报道，开窗术有可能形成动脉瘤，似乎有一个相对较高的发生率破裂，如果伴随着动脉瘤。弹簧圈栓塞是治疗动脉瘤的一种良好选择，当存在多个动脉瘤时应考虑弹簧圈栓塞，因为可以同时治疗所有动脉瘤。小动脉干的近端闭塞是可以接受的，因为远端有逆行血流，即使存在。
BACKGROUND AND IMPORTANCE: We present a rare case of fenestration of the left supraclinoid intracranial internal carotid artery with 2 associated aneurysms arising proximally and distally from the fenestration that were successfully treated with endovascular coil embolization. This is the first report of these types of aneurysms treated with coiling alone.CLINICAL PRESENTATION: A 47-year-old woman underwent a diagnostic workup; magnetic resonance angiography incidentally revealed 2 tandem aneurysms at the supraclinoid and paraclinoid portion of the left internal carotid artery. Angiography revealed fenestration of the left supraclinoid internal carotid artery with 2 aneurysms both proximal and distal to the fenestration. The patient underwent endovascular coil embolization of the aneurysms simultaneously. The smaller trunk was intentionally occluded to achieve complete packing of the proximal aneurysm. Both aneurysms were totally occluded, and no neurological deficits developed in the patient.CONCLUSION: Based on previous reports, fenestration has the potential to form an aneurysm, and there seemed to be a relatively high incidence of rupture if accompanied by aneurysm. Coiling is one good option to treat aneurysms and should be considered when multiple aneurysms exist because all aneurysms can be treated simultaneously. Proximal occlusion of the smaller trunk is acceptable because of a retrograde flow from the distal end, even if one exists.