Flow Changes after Endovascular Treatment of a Wide-Neck Anterior Communicating Artery Aneurysm by using X-configured Kissing Stents (Cross-Kissing Stents) Technique

Zeleňák, Kamil; Zeleňáková, Jana; DeRiggo, Július; Kurča, Egon; Boudný, Jaroslav; Poláček, Hubert

doi:10.1007/s00270-011-0153-7

Cited by 10 publications

(1 citation statement)

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“…lesions and one of the aCas would have been shunted. Endovascular treatment of aneurysms located on the aComa using x-configured cross-kissing stents has been reported 19,25 , but this alternative was not suitable in our conformation as FDS meshes are too dense to allow cross-kissing. Stent implantation involves antiplatelet therapy, which constitutes a challenge in case of acute intracranial hemorrhage.…”

Section: Resultsmentioning

confidence: 87%

Endovascular Exclusion of the Anterior Communicating Artery with Flow-Diverter Stents as an Emergency Treatment for Blister-Like Intracranial Aneurysms

et al. 2013

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Blood blister-like aneurysms (BLAs) are rare lesions, associated with diffuse subarachnoid hemorrhage (SAH). BLAs tend to rebleed quickly after first bleeding and must be treated as an emergency. Acute treatment is challenging using surgical and endovascular approaches due to the fragile aneurysm wall and small sac. Flow-diverter stents (FDSs) may offer a new option for the treatment of difficult small aneurysms. We describe a case of a ruptured BLA on the anterior communicating artery (AComA) treated in the acute phase of SAH by endovascular exclusion of the AComA with deployment of two FDSs in the A1/A2 junctions of both anterior cerebral arteries (ACAs). A 61-year-old man was admitted for diffuse SAH with a focal interhemispheric hematoma. Angiography revealed multiple arterial wall irregularities on the AComA and both ACAs. We performed an endovascular shunt of the AComA by deploying two FDSs in both A1/A2 junctions. Immediate control injections confirmed flow diversion in the A1/A2 segments of the ACAs with decreased blood flow in the AComA. The patient's course in hospital was uneventful. A three-month follow-up angiogram confirmed complete exclusion of the aneurysms, complete exclusion of the AComA, and patency of the two ACAs without any persistent arterial wall irregularity. Endovascular bypass using an FDS for a ruptured BLA has never been described. It establishes a new therapeutic option despite the need for antiplatelet therapy. Endovascular AComA exclusion using an FDS may be a solution when no other treatment is available for a ruptured BLA.

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Section: Resultsmentioning

confidence: 87%