Competitive flow diversion of multiple P1 aneurysms: proposed classification.
Aneurysm, Ruptured
/ complications
Cerebral Angiography
/ methods
Cerebrovascular Circulation
/ physiology
Circle of Willis
/ diagnostic imaging
Computed Tomography Angiography
/ methods
Endovascular Procedures
/ instrumentation
Female
Humans
Intracranial Aneurysm
/ diagnostic imaging
Middle Aged
Posterior Cerebral Artery
/ diagnostic imaging
Stents
Subarachnoid Hemorrhage
/ diagnosis
Therapies, Investigational
Treatment Outcome
aneurysm
blood flow
flow diverter
subarachnoid
technique
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
03 Jun 2020
03 Jun 2020
Historique:
entrez:
6
6
2020
pubmed:
6
6
2020
medline:
13
2
2021
Statut:
epublish
Résumé
We report the case of a patient with subarachnoid hemorrhage and three aneurysms arising from the posterior communicating artery (Pcomm)-P1 complex, treated with endovascular coiling and competitive flow diversion. The largest and likely ruptured Pcomm aneurysm was treated with traditional coiling. Two smaller potentially ruptured aneurysms arose from the distal right posterior cerebral artery (PCA) P1 segment. After a failed attempt to treat with conventional flow diversion across the PCA-P1 segment, the P1 aneurysms were successfully treated with competitive flow diversion distal to the PCA-P1 segment from Pcomm to the P2 segment. Over 12 months, competitive flow diversion redirected flow to the right PCA territory via the internal carotid artery-Pcomm-P2, reducing the size of the PCA-P1 segment and obliterating the P1 aneurysms. Competitive flow diversion treatment should be considered for aneurysms occurring at the circle of Willis when traditional methods are not feasible. Herein, we introduce a novel classification for competitive flow diversion treatment.
Identifiants
pubmed: 32499293
pii: 13/6/e015581
doi: 10.1136/bcr-2019-015581
pmc: PMC7279675
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Neurosurgery. 2014 Mar;10 Suppl 1:E161-6; discussion E166
pubmed: 23787883
JAMA Neurol. 2016 Aug 1;73(8):1002-8
pubmed: 27294446
Neurocrit Care. 2017 Jun;26(3):465-473
pubmed: 27844465
Neurointervention. 2016 Mar;11(1):46-9
pubmed: 26958413
AJNR Am J Neuroradiol. 2017 Mar;38(3):590-595
pubmed: 28007770