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Jorge Rios-Zermeno,Leoncio Alberto Tovar-Romero,Gerardo Cano-Velazquez,Ricardo Marian-Magana,Marcos Sangrador-Deitos,Juan Luis Gomez-Amador 대한뇌혈관외과학회 2023 Journal of Cerebrovascular and Endovascular Neuros Vol.25 No.3
Intracranial aneurysms arise in 1-2% of the population and usually present as hemorrhagic strokes. Spontaneous thrombosis of a ruptured intracranial aneurysm occurs in 1-3% and most commonly in giant aneurysms, with complete thrombosis in just 13-20% of the cases. Thrombosis of smaller aneurysms is rare. Here we present a case of a patient who presented with a ruptured intracranial aneurysm that subsequently thrombosed, discovering a neighboring de-novo aneurysm during follow-up. We hypothesized that after thrombosis, the hemodynamic characteristics that contributed to the formation of the first aneurysm were replicated.
Intra-aneurysmatic thrombectomy in a distal anterior cerebral artery aneurysm
Juan Luis Gómez-Amador,Leoncio Alberto Tovar-Romero,Andrea Castillo-Matus,Ricardo Marian-Magaña,Jorge Fernando Aragón-Arreola,Marcos Vinicius Sangrador-Deitos,Alan Hernández-Hernández,Germán López-Val 대한뇌혈관외과학회 2023 Journal of Cerebrovascular and Endovascular Neuros Vol.25 No.4
Thrombectomy procedures following intra-aneurysmatic lesions are extremely rare, and few cases have been reported. This article describes a microsurgical intra-aneurysmatic thrombectomy (MIaT) for a distal anterior cerebral artery (DACA) aneurysm. We present the case of a 48-year-old female that was admitted to the emergency room, showing neurologic deterioration with focal deficits. A computed tomography angiography (CTA) scan revealed an aneurysm located in the distal segment of the left anterior cerebral artery. During the surgical procedure, after clipping, a wellformed clot was visualized through the aneurysm’s wall obstructing the left DACA flow. We proceeded to open the aneurysm’s dome to remove the thrombus and clip the aneurysm neck, re-establishing the flow of the left DACA.Intra-aneurysmatic thrombosis can occur as a complication during clipping, obstructing the distal flow of vital arteries and causing fatal results in the patient’s postoperative status. MIaT is a good technique for restoring the flow of the affected vessel and allows a secure aneurysm clipping after thrombus removal.