Flow Diverter for the Treatment of Pseudoaneurysms of the Extracraneal Vertebral Artery: Report of Two Cases and Review of the Literature
| Autor: | Ricardo García-Mónaco, Santiago Hem, Sofia Beltrame, Claudio Yampolsky, Pedro Plou, Federico Landriel, Oscar Peralta |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Vertebral artery medicine.medical_treatment Arteriovenous fistula Dissection (medical) 03 medical and health sciences 0302 clinical medicine Aneurysm medicine.artery medicine Foramen Humans Embolization Vertebral Artery Flow diverter Vertebral Artery Dissection business.industry Endovascular Procedures Cervical Cord Middle Aged medicine.disease Embolization Therapeutic Thrombosis Surgery Treatment Outcome 030220 oncology & carcinogenesis Female Stents Neurology (clinical) business Aneurysm False 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 127:72-78 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2019.03.098 |
| Popis: | Background Pseudoaneurysms (PAs) of the extracranial vertebral artery (VA) are rare lesions, representing less than 1% of all aneurysms. Although these lesions may resolve spontaneously, they present a high rupture rate, so early preventive treatment is advised. Case Description Case 1: A 48-year-old woman presented with pain and cervical rigidity. An angiotomography showed a PA of the left VA at the level of the C2 transverse foramen, with mural thrombosis and bone remodeling of the left lateral mass. The PA was treated with the endovascular placement of a flow diverter stent. The patient was discharged 3 days after the procedure without complications. The last vascular imaging follow-up was performed 6 years after the procedure showing a patent left VA, with complete resolution of the aneurysm. Case 2: A 57-year-old woman was admitted referring cervicalgia after a polytraumatism. An angiotomography revealed a fracture of the C1 posterior arch, lateral mass, and left transverse foramen, on top of a left VA thrombosis due to a vascular dissection. Eleven months after the trauma, a left VA V3 segment arteriovenous fistula developed. It was treated with hydrocoils, with no complications. One month after the embolization, a left VA V3 segment PA was observed and treated with a flow diverter stent. An angiographic follow-up 2 years after the procedure showed a patent left VA, with complete resolution of the PA. Conclusion The use of flow diverters seems to be a safe and effective therapeutic option for the treatment of PAs of the extracranial VAs. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect