Yamaguchi Shinya, Ito Osamu, Imamoto Naoyuki, Murata Hideki, Maeda Yoshihisa, Yuhi Fumiaki, Natori Yoshihiro, Matsukado Koichiro
Department of Neurosurgery, Hamanomachi Hospital, Fukuoka, Japan.
No Shinkei Geka. 2011 Feb;39(2):171-6.
A posterior cerebral artery aneurysm is a rare condition. Various surgical approaches have to be considered for operating on these aneurysms because the position of the aneurysm and the surrounding structures restrict the operative field and render the operation difficult. Recently, endovascular treatments for posterior cerebral artery aneurysms have been reported to provide a good outcome. We present a case of a ruptured posterior cerebral artery aneurysm treated with coil embolization. We adopted endovascular treatment because a large vein of Labbé was expected to restrict the operative field. The internal carotid artery and a fetal-type posterior communicating artery (PCoA) were chosen as the access route because of P1 hypoplasty, and a coaxial guiding system was used because of the tortuous access route. The aneurysm was suitably embolized using Guglielmi detachable coils (GDCs). In a case of posterior cerebral artery aneurysm, we report the usefulness of endovascular treatment performed through the internal carotid artery and a fetal-type PCoA.
大脑后动脉动脉瘤是一种罕见病症。由于动脉瘤的位置及周围结构限制了手术视野并使手术难度增大，因此在对这些动脉瘤进行手术时必须考虑多种手术入路。近来，有报道称大脑后动脉动脉瘤的血管内治疗效果良好。我们报告一例采用弹簧圈栓塞治疗的破裂大脑后动脉动脉瘤病例。由于预期Labbe大静脉会限制手术视野，我们采用了血管内治疗。因P1段发育不全，选择颈内动脉和胎儿型后交通动脉（PCoA）作为入路途径，又因入路途径迂曲，使用了同轴引导系统。使用 Guglielmi 可脱性弹簧圈（GDC）对动脉瘤进行了适当栓塞。对于大脑后动脉动脉瘤病例，我们报告了经颈内动脉和胎儿型PCoA进行血管内治疗的有效性。
