Department of Neurosurgery, Kyoto Okamoto Memorial Hospital.
Neurol Med Chir (Tokyo). 2023 Jun 15;63(6):258-263. doi: 10.2176/jns-nmc.2022-0309. Epub 2023 Mar 31.
Horizontal stenting protects the aneurysm neck with stent deployment across the aneurysm neck via the circle of Willis. A saccular aneurysm associated with intracranial arterial fenestration is very rare. Herein, we describe the first case of an unruptured aneurysm related to intracranial arterial fenestration treated with horizontal stenting. A 23-year-old woman presented with a 7-mm broad-necked aneurysm at the fenestration of the right intracranial vertebral artery (VA), which was incidentally found on magnetic resonance imaging. The patient underwent endovascular treatment with horizontal stenting via the vertebrobasilar junction from the contralateral left VA, followed by coil embolization using a jailed microcatheter from the ipsilateral right VA. The procedure was finished with sufficient embolization, and no complications occurred. Horizontal stent delivery via the vertebrobasilar junction for coil embolization of a broad-necked aneurysm arising from the fenestration of the VA is a safe and effective therapeutic strategy.
水平支架通过 Willis 环在动脉瘤颈部跨越动脉瘤颈部来保护动脉瘤颈部。与颅内动脉开窗相关的囊状动脉瘤非常罕见。在此，我们描述首例经水平支架治疗的与颅内动脉开窗相关的未破裂动脉瘤。一位 23 岁女性因右侧颅内椎动脉（VA）开窗处存在 7mm 宽颈动脉瘤而就诊，该动脉瘤是在磁共振成像上偶然发现的。患者从对侧左 VA 通过椎基底交界行水平支架置入术，随后从同侧右 VA 用微导管进行线圈栓塞。该手术完成充分栓塞，且无并发症发生。通过椎基底交界行水平支架输送以对起源于 VA 开窗处的宽颈动脉瘤进行线圈栓塞是一种安全有效的治疗策略。
