Ikezawa Mizuka, Takasu Syuntaro, Nishihori Masahiro, Yokoyama Kinya, Somiya Daiki, Sasaki Kei, Ikeda Akira, Maeda Kenko, Saito Ryuta
Department of Neurosurgery, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Aichi, Japan.
Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
J Neuroendovasc Ther. 2025;19(1). doi: 10.5797/jnet.cr.2025-0051. Epub 2025 Aug 5.
Formation of an aneurysm at the anastomosis site is a rare complication of superficial temporal artery-middle cerebral artery (STA-MCA) bypass for moyamoya disease (MMD). All 5 previously reported cases were treated with craniotomy, and no case of endovascular treatment has been reported to date. Here, we report a case in which endovascular treatment was performed for an anastomotic aneurysm that developed after STA-MCA bypass surgery for MMD.
A 46-year-old woman with no relevant medical history developed a cerebral hemorrhage and was diagnosed with MMD. Bilateral STA-MCA bypass was performed to prevent recurrence of bleeding, and a de novo aneurysm was found at the right anastomosis site 1 year after the surgery. After a 2-year follow-up period, the size of the aneurysm and the diameter of the STA increased; therefore, treatment was initiated. Endovascular treatment was performed using the double-catheter technique. After coil embolization, the aneurysm was no longer visible, and no complications were observed.
Anastomotic aneurysms after STA-MCA bypass can be safely and effectively treated with endovascular therapy.
吻合口处动脉瘤形成是烟雾病（MMD）颞浅动脉-大脑中动脉（STA-MCA）搭桥术罕见的并发症。此前报道的所有5例病例均采用开颅手术治疗，迄今为止尚无血管内治疗的病例报道。在此，我们报告1例因MMD行STA-MCA搭桥术后发生吻合口动脉瘤而接受血管内治疗的病例。
一名无相关病史的46岁女性发生脑出血，被诊断为MMD。为预防出血复发，行双侧STA-MCA搭桥术，术后1年在右侧吻合口处发现一个新生动脉瘤。经过2年的随访期，动脉瘤大小及STA直径均增大；因此，开始进行治疗。采用双导管技术进行血管内治疗。弹簧圈栓塞后，动脉瘤不再显影，且未观察到并发症。
STA-MCA搭桥术后的吻合口动脉瘤可通过血管内治疗安全有效地进行治疗。
