Delayed thrombosis of a complex fusiform ICA aneurysm treated with flow reversal and partial occlusion: case report and brief review of possible mechanisms

Immediate complete occlusion of complex cerebral aneurysms associated with perforating or major branch arteries may cause serious ischemic complications due to poor collateral supply. Flow reversal with concomitant proximal occlusion is an important therapeutic strategy in clinical practice and indu...

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Bibliographic Details
Published in:Neuroradiology 2011-06, Vol.53 (6), p.461-465
Main Authors: Oruckaptan, H. Hakan, Cekirge, H. Saruhan
Format: Article
Language:English
Subjects:
Aneurysms
Biological and medical sciences
Cardiovascular system
Carotid Artery, Internal - diagnostic imaging
Carotid Artery, Internal - pathology
Cerebral Angiography
Embolization, Therapeutic - instrumentation
Embolization, Therapeutic - methods
Humans
Imaging
Interventional Neuroradiology
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - pathology
Intracranial Aneurysm - therapy
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Nervous system
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Radiology
Severity of Illness Index
Thrombosis
Thrombosis - chemically induced
Treatment Outcome
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Description
Summary:Immediate complete occlusion of complex cerebral aneurysms associated with perforating or major branch arteries may cause serious ischemic complications due to poor collateral supply. Flow reversal with concomitant proximal occlusion is an important therapeutic strategy in clinical practice and induces gradual thrombosis in the aneurysm within weeks or months, providing a time window for collateral progression. Herein, we report a case of delayed thrombosis of a complex fusiform aneurysm of the ICA following flow reversal with EC-IC bypass and concomitant partial coiling with parent artery occlusion. The effects of hemodynamic alterations on collateral circulation and intra-aneurysmal thrombosis are briefly discussed in the light of the literature.
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-010-0791-5