Hybrid treatment for a giant thrombosed aneurysm at the distal posterior cerebral artery: A case report and literature review
Hybrid treatment for a giant thrombosed aneurysm at the distal posterior cerebral artery: A case report and literature review
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大脑后动脉远端巨大血栓性动脉瘤的综合治疗：病例报告及文献复习
DOI：
10.1016/j.inat.2020.100864
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Matsuo Takayuki
中科院分区：
文献类型：
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作者：
Morofuji Yoichi;Izumo Tsuyoshi;Sadakata Eisaku;Maeda Hajime;Horie Nobutaka;Matsuo Takayuki
大脑后动脉远端 (PCA) 的巨大动脉瘤极其罕见，迄今为止仅报告了不到 30 例。本报告介绍了部分血栓形成的巨大动脉瘤并讨论了治疗策略。一名 63 岁男性出现步态障碍，有 1 年不断扩大的巨大血栓性 PCA (P2) 动脉瘤病史，被转诊至我们科室。术前球囊闭塞测试显示患者对载瘤动脉闭塞的不耐受。因此，我们采用枕动脉-桡动脉介入-PCA (P3) 旁路的混合策略，通过枕叶半球间入路，然后进行血管内内部捕获。 P3 段的搭桥手术具有挑战性，但如果患者不能耐受球囊测试闭塞，则应进行搭桥手术并闭塞载瘤动脉。
Giant aneurysms at the distal posterior cerebral artery (PCA) are extremely rare, with only <30 cases previously reported to date. This report presents a partially thrombosed giant aneurysm and discusses the treatment strategy. A 63-year-old man presenting gait disturbance, with 1-year history of an enlarging giant thrombosed PCA (P2) aneurysm, was referred to our department. Preoperative balloon test occlusion revealed the patient’s intolerance to the parent artery occlusion. Therefore, we performed hybrid strategy with occipital artery – radial artery interposition – PCA (P3) bypass via an occipital interhemispheric approach followed by an endovascular internal trapping. Bypass surgery at the P3 segment is challenging, but the bypass followed by parent artery occlusion should be performed in case the patient is intolerant for balloon test occlusion.