[A case of a vertebral artery fusiform aneurysm treated with stent assisted coil embolization: technique to prevent coil migration]. 2006

Kentaro Hayashi, and Naoki Kitagawa, and Minoru Morikawa, and Jun-ichi Kawakubo, and Takeshi Hiu, and Nobutaka Horie, and Keisuke Tsutsumi, and Izumi Nagata
Department of Neurosurgery, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki-city, Nagasaki 852-8501, Japan.

Placement of a stent over the aneurysm neck and secondary coil embolization prevents coil migration and allows attenuated packing of the coils. However, during the course of the embolization, coils project over and obscure the parent vessel. Here we report a novel technique for endovascular parent vessel reconstruction with aneurysm embolization. A 73-year-old male had an incidental fusiform aneurysm at the V4 segment of the left vertebral artery. The size of the aneurysm increased from 7 mm to 8 mm in diameter. Since the right vertebral artery was hypoplastic, endovascular parent vessel reconstruction with coil embolization was performed. A flexible balloon-expandable coronary stent was navigated to the lesion and deployed successfully followed by coil embolization using a microcatheter through the stent. The balloon was inflated intermittently during coil insertion avoiding coil migration to inside the stent. Furthermore, the angle of the image intensifier was manipulated to visualize the inside of the stent. Postoperative course was uneventful and follow-up MRI three moths later demonstrated obliteration of the aneurysm and patency of the parent artery. This technique provides a practical treatment strategy for the management of a circumferential aneurysm.

UI MeSH Term Description Entries
D008297 Male Males
D002532 Intracranial Aneurysm Abnormal outpouching in the wall of intracranial blood vessels. Most common are the saccular (berry) aneurysms located at branch points in CIRCLE OF WILLIS at the base of the brain. Vessel rupture results in SUBARACHNOID HEMORRHAGE or INTRACRANIAL HEMORRHAGES. Giant aneurysms (>2.5 cm in diameter) may compress adjacent structures, including the OCULOMOTOR NERVE. (From Adams et al., Principles of Neurology, 6th ed, p841) Aneurysm, Cerebral,Aneurysm, Intracranial,Basilar Artery Aneurysm,Berry Aneurysm,Brain Aneurysm,Cerebral Aneurysm,Giant Intracranial Aneurysm,Mycotic Aneurysm, Intracranial,Aneurysm, Anterior Cerebral Artery,Aneurysm, Anterior Communicating Artery,Aneurysm, Basilar Artery,Aneurysm, Middle Cerebral Artery,Aneurysm, Posterior Cerebral Artery,Aneurysm, Posterior Communicating Artery,Anterior Cerebral Artery Aneurysm,Anterior Communicating Artery Aneurysm,Middle Cerebral Artery Aneurysm,Posterior Cerebral Artery Aneurysm,Posterior Communicating Artery Aneurysm,Aneurysm, Berry,Aneurysm, Brain,Aneurysm, Giant Intracranial,Aneurysm, Intracranial Mycotic,Aneurysms, Basilar Artery,Aneurysms, Berry,Aneurysms, Brain,Aneurysms, Cerebral,Aneurysms, Giant Intracranial,Aneurysms, Intracranial,Aneurysms, Intracranial Mycotic,Artery Aneurysm, Basilar,Artery Aneurysms, Basilar,Basilar Artery Aneurysms,Berry Aneurysms,Brain Aneurysms,Cerebral Aneurysms,Giant Intracranial Aneurysms,Intracranial Aneurysm, Giant,Intracranial Aneurysms,Intracranial Aneurysms, Giant,Intracranial Mycotic Aneurysm,Intracranial Mycotic Aneurysms,Mycotic Aneurysms, Intracranial
D004621 Embolization, Therapeutic A method of hemostasis utilizing various agents such as Gelfoam, silastic, metal, glass, or plastic pellets, autologous clot, fat, and muscle as emboli. It has been used in the treatment of spinal cord and INTRACRANIAL ARTERIOVENOUS MALFORMATIONS, renal arteriovenous fistulas, gastrointestinal bleeding, epistaxis, hypersplenism, certain highly vascular tumors, traumatic rupture of blood vessels, and control of operative hemorrhage. Embolotherapy,Therapeutic Embolization,Embolizations, Therapeutic,Embolotherapies,Therapeutic Embolizations
D005548 Foreign-Body Migration Migration of a foreign body from its original location to some other location in the body. Foreign Body Migration,Foreign-Body Migrations,Migration, Foreign-Body,Migrations, Foreign-Body
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D014711 Vertebral Artery The first branch of the SUBCLAVIAN ARTERY with distribution to muscles of the NECK; VERTEBRAE; SPINAL CORD; CEREBELLUM; and interior of the CEREBRUM. Vertebral Arteries,Arteries, Vertebral,Artery, Vertebral
D015607 Stents Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting. Stent

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