Department of Neurosurgery, Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey.
Neuroradiology. 2011 Jun;53(6):461-5. doi: 10.1007/s00234-010-0791-5. Epub 2010 Nov 16.
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.
由于侧支循环供应较差，立即完全闭塞与穿通动脉或主要分支动脉相关的复杂脑动脉瘤可能导致严重的缺血性并发症。伴有近端闭塞的血流反转是临床实践中的重要治疗策略，可在数周或数月内导致动脉瘤逐渐血栓形成，为侧支循环进展提供时间窗口。在此，我们报告了一例颈内动脉复杂梭形动脉瘤在颅内外旁路联合部分弹簧圈栓塞伴载瘤动脉闭塞后发生的延迟性血栓形成。根据文献简要讨论了血流动力学改变对侧支循环和瘤内血栓形成的影响。
