Maiuri F, Spaziante R, Iaconetta G, Signorelli F, Cirillo S, Di Salle F
Institute of Neurosurgery, School of Medicine, University of Naples Federico II, Italy.
Clin Neurol Neurosurg. 1995 Aug;97(3):233-8. doi: 10.1016/0303-8467(95)00035-i.
We report 2 cases of 'de novo' aneurysm formation in a vessel which appeared to be normal at a previous angiography. The first patient developed an anterior communicating artery aneurysm nine years after occlusion of the right internal carotid artery by Gianturco coils for the treatment of a giant intracavernous carotid aneurysm. In the second case a 'de novo' aneurysm of the internal angle A1-A2 segment of the left anterior cerebral artery developed 6 years after successful clipping of another aneurysm of the same location. De novo formation of an aneurysm in a vessel which was found to be normal in a previous angiographic study, may occur as result of hemodynamic changes, such as after internal carotid occlusion or in presence of an arteriovenous malformation or variations of the circle of Willis. However, definite hemodynamic changes may also be absent. We conclude that patients operated on for aneurysm clipping must be periodically explored by magnetic resonance angiography to evaluate the possibility of de novo appearance of another aneurysm.
我们报告了2例在先前血管造影显示正常的血管中“新发”动脉瘤形成的病例。第一例患者在因巨大海绵窦段颈内动脉瘤采用吉特鲁科弹簧圈栓塞右侧颈内动脉9年后，出现了前交通动脉瘤。第二例患者在成功夹闭同一部位的另一个动脉瘤6年后，出现了左大脑前动脉A1 - A2段内转角处的“新发”动脉瘤。在先前血管造影研究中显示正常的血管中出现新发动脉瘤，可能是由于血流动力学改变所致，比如颈内动脉闭塞后、存在动静脉畸形或 Willis 环变异时。然而，也可能不存在明确的血流动力学改变。我们得出结论，接受动脉瘤夹闭手术的患者必须定期进行磁共振血管造影检查，以评估出现另一个新发动脉瘤的可能性。
