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经血管内治疗上基底动脉开窗小分支处动脉瘤:病例展示

Endovascular treatment of an aneurysm arising from the minor limb of an upper basilar artery fenestration: illustrative case.

作者信息

Matsuo Ayaka, Hiu Takeshi, Otsuka Hiroaki, Miyazaki Atsushi, Haraguchi Wataru, Kawahara Ichiro, Ono Tomonori, Izumo Tsuyoshi, Matsuo Takayuki, Tsutsumi Keisuke

机构信息

1Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; and.

Departments of2Neurosurgery and.

出版信息

J Neurosurg Case Lessons. 2022 Jul 25;4(4):CASE22180. doi: 10.3171/CASE22180.

Abstract

BACKGROUND

An aneurysm arising in an upper basilar artery (BA) fenestration is extremely rare. The authors reported a case involving successful endovascular treatment of an aneurysm arising from the minor limb of an upper BA fenestration.

OBSERVATIONS

A 65-year-old woman presented with an incidentally detected upper BA aneurysm arising from the minor limb of an upper BA fenestration. The irregularly shaped aneurysm was 6.0 × 2.7 mm in diameter, and the minor limb had several perforators. The aneurysm was nearly completely occluded with a catheter-assisted technique. The authors preserved both limbs of the BA fenestration. The postoperative course was uneventful, and the patient had an excellent clinical course with no neurological deficits or aneurysmal recanalization.

LESSONS

The case is the first report of an unruptured aneurysm arising at the minor limb of an upper BA fenestration. In this case, the authors preserved the minor limb with endovascular treatment. The authors believe catheter-assisted coil embolization to be a feasible endovascular technique in such cases.

摘要

背景

起源于基底动脉上段开窗处的动脉瘤极为罕见。作者报告了一例成功通过血管内治疗起源于基底动脉上段开窗处较小分支的动脉瘤的病例。

观察结果

一名65岁女性偶然发现起源于基底动脉上段开窗处较小分支的动脉瘤。该动脉瘤形状不规则,直径为6.0×2.7毫米,较小分支有几支穿支血管。采用导管辅助技术几乎完全闭塞了动脉瘤。作者保留了基底动脉开窗处的两个分支。术后过程顺利,患者临床恢复良好,无神经功能缺损或动脉瘤再通。

经验教训

该病例是关于起源于基底动脉上段开窗处较小分支的未破裂动脉瘤的首例报告。在此病例中,作者通过血管内治疗保留了较小分支。作者认为导管辅助弹簧圈栓塞在此类病例中是一种可行的血管内技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab84/9329865/d61c9ace0961/CASE22180f1.jpg

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