The Use of a Pipeline Embolization Device for Treatment of a Ruptured Dissecting Middle Cerebral Artery M3/M4 Aneurysm: Challenges and Technical Considerations
The Use of a Pipeline Embolization Device for Treatment of a Ruptured Dissecting Middle Cerebral Artery M3/M4 Aneurysm: Challenges and Technical Considerations
Berwanger Robert P.(Indiana University School of Medicine, Indianapolis, IN, USA); Hoover Madeline C.(Indiana University School of Medicine, Indianapolis, IN, USA); Scott John A.(Goodman Campbell Brain and Spine at Ascension St. Vincent Hospital, Carmel, IN, USA); DeNardo Andrew J.(Goodman Campbell Brain and Spine at Ascension St. Vincent Hospital, Carmel, IN, USA); Amuluru Krishna(Goodman Campbell Brain and Spine at Ascension St. Vincent Hospital, Carmel, IN, USA); Payner Troy D.(Goodman Campbell Brain and Spine at Ascension St. Vincent Hospital, Carmel, IN, USA); Kulwin Charles G.(Goodman Campbell Brain and Spine at Ascension St. Vincent Hospital, Carmel, IN, USA); Sahlein Daniel H.(Goodman Campbell Brain and Spine at Ascension St. Vincent Hospital, Carmel, IN, USA)
17권 2호, 126~130쪽
초록
Prompt, effective treatment is necessary following aneurysmal subarachnoid hemorrhage to prevent recurrent rupture, which is thought to double mortality. Atypical ruptured aneurysms, such as blister or dissecting pseudoaneurysms, or those that are unusually distal in the middle cerebral artery (MCA) are challenging to treat with either open or endovascular options, though the pipeline embolization device (PED) has shown promise in multiple case series. We present a case of a ruptured dissecting pseudoaneurysm in the distal MCA (distal M3/proximal M4) prefrontal division in an healthy young patient (<60 years) successfully treated with a PED. The PED was chosen both as the only vessel sparing option in the young patient as well as for its potential as a vessel sacrifice tool if the pseudoaneurysm was felt to be incompletely treated, which in this case was not necessary—though would have leveraged the thrombogenicity of the device as a therapeutic advantage.
Abstract
Prompt, effective treatment is necessary following aneurysmal subarachnoid hemorrhage to prevent recurrent rupture, which is thought to double mortality. Atypical ruptured aneurysms, such as blister or dissecting pseudoaneurysms, or those that are unusually distal in the middle cerebral artery (MCA) are challenging to treat with either open or endovascular options, though the pipeline embolization device (PED) has shown promise in multiple case series. We present a case of a ruptured dissecting pseudoaneurysm in the distal MCA (distal M3/proximal M4) prefrontal division in an healthy young patient (<60 years) successfully treated with a PED. The PED was chosen both as the only vessel sparing option in the young patient as well as for its potential as a vessel sacrifice tool if the pseudoaneurysm was felt to be incompletely treated, which in this case was not necessary—though would have leveraged the thrombogenicity of the device as a therapeutic advantage.
- 발행기관:
- 대한신경중재치료의학회
- 분류:
- 중재적진단방사선학