未破裂動脈瘤クリッピング術後に増大し血栓化巨大中大脳動脈瘤となった1例(<特集>困難を極めた症例・特別なテクニックを要した症例)  [in Japanese] A Giant Thrombosed Aneurysm of Middle Cerebral Artery Grown after Clipping of an Unruptured Aneurysm : A Case Report(Topics : Special Technique for Complex and Unusual Lesion)  [in Japanese]

A 64-year-old woman underwent clipping surgery on a left unruptured middle cerebral artery aneurysm. A neck remnant was coated with cyanoacrylate glue (Biobond). Six years later, imaging revealed a giant thrombosed aneurysm at the same site. At re-operation, the 2 clips, which were used at the initial operation, were both found to be buried in the thrombosed aneurysmal wall. Aneurysmotomy and re-clipping were performed successfully. Although recurrence of the aneurysm after surgical obliteration is not uncommon, intraaneurysmal thrombosis and severe granulomatous change are seldom reported in the recurrent cases. These histological changes may be caused by Biobond. A long-term follow-up study is necessary to detect de novo aneurysms and recurrence of clipped aneurysms.