Flow Diverter Therapy of a Giant Fusiform Vertebrobasilar Junction Aneurysm in a Child: Case Report

Oishi, Hidenori; Teranishi, Kosuke; Yatomi, Kenji; Fujii, Takashi; Yamamoto, Munetaka; Arai, Hajime

doi:10.2176/nmccrj.cr.2018-0166

Cited by 2 publications

(5 citation statements)

References 10 publications

(6 reference statements)

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“…In 2018, Oishi et al also reported the results of Pipeline insertion in 94 patients (100 aneurysms); in-stent stenosis developed in one patient. 6) Even when in-stent stenosis is observed after the deployment of Pipeline, it rarely becomes symptomatic, requiring additional treatment. 12) Furthermore, neo-intimal hyperplasia is considered to be an etiological factor for in-stent stenosis.…”

Section: Discussionmentioning

confidence: 99%

“…one patient. 6) Even when in-stent stenosis is observed after the deployment of Pipeline, it rarely becomes symptomatic, requiring additional treatment. 12) Furthermore, neo-intimal hyperplasia is considered to be an etiological factor for in-stent stenosis.…”

Section: Journal Of Neuroendovascular Therapymentioning

confidence: 99%

“…The results of Pipeline placement in aneurysms that had been considered to be refractory were favorable. 6) At our hospital, the deployment of Pipeline was performed in 69 patients (70 aneurysms) between June 2015 and December 2019. Of these, we report a patient with a large ICA paraclinoid aneurysm in whom in-stent stenosis developed after the deployment of Pipeline, requiring parent artery occlusion, and review the literature.…”

Section: Introductionmentioning

confidence: 99%

“…The results of Pipeline placement in aneurysms that had been considered to be refractory were favorable. 6) …”

Section: Introductionmentioning

confidence: 99%

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A Patient with a Large Aneurysm Complicated by Stenosis of the Internal Carotid Artery Distal to the Aneurysm in Whom Treatment Using a Pipeline Flex Was Performed

Hiramatsu

Ohnishi

Yagi

et al. 2020

JNET

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This case necessitated retreatment for parent artery occlusion.Case Presentation: A 55-year-old woman with right-side visual disorder was referred to our hospital for the deployment of Pipeline Flex. Cerebral digital subtraction angiography (DSA) demonstrated a large right-side paraclinoid aneurysm in combination with severe internal carotid artery (ICA) stenosis just beyond the aneurysm. We deployed Pipeline Flex under general anesthesia. After deployment, we performed angioplasty through the Pipeline. Six months after deployment, this patient exhibited exacerbation of visual disorder. Follow-up DSA revealed in-stent stenosis at 6 months after the deployment of Pipeline Flex. Therefore, we performed parent artery occlusion. Right-side visual disorder was improved in this patient. Conclusion:If Pipeline is deployed for patients with ICA stenosis just beyond an aneurysm, we need to be aware of instent stenosis after deployment.

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Section: Discussionmentioning

confidence: 99%

Section: Journal Of Neuroendovascular Therapymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The results of Pipeline placement in aneurysms that had been considered to be refractory were favorable. 6) …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Patient with a Large Aneurysm Complicated by Stenosis of the Internal Carotid Artery Distal to the Aneurysm in Whom Treatment Using a Pipeline Flex Was Performed

Hiramatsu

Ohnishi

Yagi

et al. 2020

JNET

View full text Add to dashboard Cite

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“…[4][5][6][7] Additionally, complex cases can require a combination of FDs with direct surgery and other endovascular methods. [8][9][10] Techniques involve altering the blood flow by occluding vessels before stent placement to transform the aneurysm into a sidewall type, thereby improving occlusion rates. However, few studies have simulated hemodynamic changes in such treatments.…”

mentioning

confidence: 99%

A vertebrobasilar junction aneurysm successfully treated with a combination of surgical clipping and flow diverter placement based on the results of computational fluid dynamics analysis: illustrative case

Mori,

Kimura,

Fujita

et al. 2024

Journal of Neurosurgery: Case Lessons

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BACKGROUND The treatment of vertebrobasilar junction (VBJ) aneurysms is challenging. Although flow diverters (FDs) are a possible treatment option, geometrical conditions hinder intervention. VBJ aneurysms possess dual inflow vessels from the bilateral vertebral arteries (VAs), one of which is ideally occluded prior to FD treatment. However, it remains unclear which VA should be occluded. OBSERVATIONS A 75-year-old male with a growing VBJ complex aneurysm exhibiting invagination toward the brainstem and causing perifocal edema required intervention. Preoperative computational fluid dynamics (CFD) analysis demonstrated that left VA occlusion would result in more stagnant flow and less impingement of flow than right VA occlusion. According to the simulated strategy, surgical clipping of the left VA just proximal to the aneurysm was performed, followed by FD placement from the basilar artery trunk to the right VA. The patient demonstrated tolerance of the VA occlusion, and follow-up computed tomography angiography at 18 months after FD treatment confirmed the disappearance of the aneurysm. LESSONS Preoperative flow dynamics simulations using CFD analysis can reveal an optimal treatment strategy involving a hybrid surgery that combines FD placement and direct surgical occlusion for a VBJ complex aneurysm.

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Flow Diverter Therapy of a Giant Fusiform Vertebrobasilar Junction Aneurysm in a Child: Case Report

Cited by 2 publications

References 10 publications

A Patient with a Large Aneurysm Complicated by Stenosis of the Internal Carotid Artery Distal to the Aneurysm in Whom Treatment Using a Pipeline Flex Was Performed

A Patient with a Large Aneurysm Complicated by Stenosis of the Internal Carotid Artery Distal to the Aneurysm in Whom Treatment Using a Pipeline Flex Was Performed

A vertebrobasilar junction aneurysm successfully treated with a combination of surgical clipping and flow diverter placement based on the results of computational fluid dynamics analysis: illustrative case

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