Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
J Neurointerv Surg. 2010 Dec;2(4):368-70. doi: 10.1136/jnis.2010.002253. Epub 2010 May 6.
Occasionally an aneurysm is the cause of hemorrhage in patients with moyamoya disease (MMD). We present a case of a ruptured intraventricular distal anterior choroidal artery (AChA) aneurysm treated with n-butyl cyanoacrylic acid (nBCA) (Trufill nBCA Liquid Embolic, Codman Neurovascular, Raynham, Massachusetts, USA) embolization in a patient with MMD. There were no procedural complications and at 6 month follow-up she remained neurologically normal. Six month follow-up cerebral angiography showed no residual aneurysm. The endovascular route is an attractive option for many aneurysms associated with MMD as the lesions can be treated without disturbing the moyamoya collaterals. nBCA, delivered through a flow-guided microcatheter, is a good embolic agent choice when the lesion is distal on a small vessel and when distal parent artery occlusion can be tolerated. Intraventricular AChA aneurysms are well suited for this treatment strategy.
偶尔，颅内动脉瘤是烟雾病（MMD）患者出血的原因。我们报告了一例 MMD 患者破裂的脑室远端前脉络膜动脉（AChA）动脉瘤，采用 n-丁基氰基丙烯酸酯（nBCA）（Trufill nBCA 液体栓塞剂，Codman 神经血管，雷纳姆，马萨诸塞州，美国）栓塞治疗。没有出现程序并发症，6 个月随访时她仍然神经功能正常。6 个月随访脑血管造影显示无残留动脉瘤。对于许多与 MMD 相关的动脉瘤，血管内途径是一种有吸引力的选择，因为可以在不干扰烟雾状侧支循环的情况下治疗病变。当病变位于小血管的远端且可以耐受远端母动脉闭塞时，通过血流引导微导管输送的 nBCA 是一种很好的栓塞剂选择。脑室 AChA 动脉瘤非常适合这种治疗策略。
