Tailored Flow Alteration Treatment for Intracranial Internal Carotid Artery Aneurysms : Strategy Beyond Parent Artery Occlusion With Bypass : Case Report

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著者

    • SATO Kimitoshi
    • Department of Neurosurgery, Kitasato University School of Medicine
    • YAMADA Masaru
    • Department of Neurosurgery, Kitasato University School of Medicine
    • ABE Katsutoshi
    • Department of Neurosurgery, Kitasato University School of Medicine
    • OKA Hidehiro
    • Department of Neurosurgery, Kitasato University School of Medicine
    • KURATA Akira
    • Department of Neurosurgery, Kitasato University School of Medicine
    • FUJII Kiyotaka
    • Department of Neurosurgery, Kitasato University School of Medicine

抄録

A 58-year-old woman with multiple right internal carotid artery (ICA) aneurysms detected incidentally was referred to us. Three-dimensional computed tomography (CT) angiography revealed a broad-necked paraclinoid aneurysm and an aneurysm on the C<sub>1</sub> segment. Aneurysm clipping with preservation of the anterior choroidal artery and posterior communicating artery was not possible because these vessels could not be adequately identified. Intraoperative digital subtraction angiography during obliteration of the cervical portion of the ICA confirmed retrograde flow from the extracranial-intracranial (EC-IC) bypass to the right ophthalmic artery and stagnation of flow in the aneurysms. The cervical portion of the ICA was ligated. Postoperative three-dimensional CT angiography confirmed complete occlusion of both aneurysms and absence of ischemic lesions involving branches of the ICA. Reversal of the blood flow in the ICA via the EC-IC bypass primarily into the ophthalmic artery as the flow outlet by obliterating the cervical portion of the ICA was successful. To prevent ischemia in the territory fed by the perforating arteries of the ICA, tailored flow alteration treatment may be superior to simple parent artery occlusion of the ICA with/without bypass. The pattern of flow alteration should be deliberately based on individual anatomic variations, especially the preservation of flow outlets.<br>

収録刊行物

  • Neurologia medico-chirurgica = 神経外科

    Neurologia medico-chirurgica = 神経外科 52(4), 213-216, 2012-04-15

    一般社団法人 日本脳神経外科学会

各種コード

  • NII論文ID(NAID)
    10030127834
  • NII書誌ID(NCID)
    AN00358613
  • 本文言語コード
    ENG
  • 資料種別
    NOT
  • ISSN
    04708105
  • データ提供元
    CJP書誌  J-STAGE 
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