頸部内頸動脈狭窄と同側頭蓋内脳動脈瘤を同時に血管内治療した1例 A Case with Extracranial Carotid Artery Stenosis and Concomitant Intracranial Unruptured Aneurysm Treated Simultaneously by Endovascular Treatment

We report a case of simultaneously treated extracranial carotid artery stenosis and concomitant ipsilateral intracranial unruptured aneurysm by endovascular approach. Bilateral cervical carotid artery stenosis and a left intracranial unruptured aneurysm were incidently revealed in a 68-year-old male. To minimize the risk of cerebral ischemia and rupture of aneurysm, we simultaneously treated both lesions in the same session. The patient was given general anesthesia, and left carotid artery stenting was performed with distal embolic protection. Then, a guiding catheter was passed through the stent-strut and endovascular embolization of the lt. IC-PC aneurysm was performed. The postoperative course was uneventful, and the patient underwent contralateral CAS 6 days after the first intervention. The patient discharged 6 days after the second intervention. Simultaneous treatment for such ipsilateral lesions could be an optimum treatment strategy.