Department of Neurosurgery, 38310Shiga General Hospital, Japan.
Department of Neurosurgery, Stroke Center, 13736Kokura Memorial Hospital, Japan.
Neuroradiol J. 2023 Feb;36(1):108-111. doi: 10.1177/19714009221101307. Epub 2022 May 12.
In cases of moyamoya disease, an aneurysm of the lenticulostriate artery (LSA) is a rare finding. Preventive management of rebleeding from a ruptured aneurysm of the LSA is important to avoid poor outcomes. Endovascular embolization of a ruptured LSA aneurysm with parent artery occlusion has been reported in previous cases of moyamoya disease; however, to the best of our knowledge, a ruptured aneurysm treated only with coil embolization has not been described. A 42-year-old woman presented with sudden onset of dysarthria and right hemiparesis. Putaminal hemorrhage from a ruptured aneurysm in the left LSA was detected. Angiographically, moyamoya vessels were revealed. The aneurysm in the left LSA was saccular type and seemed to be related to moyamoya disease. As the aneurysm was successfully approached with a microcatheter, coil embolization without parent artery occlusion was performed. Rebleeding from the embolized aneurysm in the LSA did not occur. This is the first report of a ruptured LSA aneurysm embolized using coils through a flow-guiding microcatheter without parent artery occlusion in a case of moyamoya disease.
在烟雾病中，豆纹动脉（LSA）的动脉瘤是一种罕见的发现。预防破裂的 LSA 动脉瘤再次出血对于避免不良后果很重要。在既往烟雾病病例中，已报道过 LSA 破裂动脉瘤的血管内栓塞伴载瘤动脉闭塞；然而，据我们所知，仅用线圈栓塞治疗破裂动脉瘤尚未被描述。一位 42 岁女性突发构音障碍和右侧偏瘫。发现左侧 LSA 破裂动脉瘤引起的壳核出血。血管造影显示烟雾病血管。左侧 LSA 的动脉瘤呈囊状，似乎与烟雾病有关。由于微导管可成功接近动脉瘤，因此未进行载瘤动脉闭塞的线圈栓塞。LSA 栓塞的动脉瘤未再出血。这是首例通过血流导向微导管在烟雾病患者中成功栓塞破裂的 LSA 动脉瘤，且未进行载瘤动脉闭塞的报道。
