Remarkable shrinkage of a thrombosed giant aneurysm by stent-assisted jam-packed coil embolization.
Jam-packed embolization
Thrombosed aneurysm
Vasa vasorum
Wall enhancement
Journal
Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836
Informations de publication
Date de publication:
2021
2021
Historique:
received:
23
05
2021
accepted:
09
06
2021
entrez:
4
8
2021
pubmed:
5
8
2021
medline:
5
8
2021
Statut:
epublish
Résumé
Large and giant aneurysms are known to involve intra-aneurysmal thrombosis and present a poor prognosis because of compression of the surrounding brain tissue with enlargement of the aneurysm. These aneurysms are difficult to cure by endovascular treatment due to involvement of the vasa vasorum in their pathology. We report this technical note to describe stent-assisted jam-packed coil embolization for the treatment of a giant thrombosed aneurysm. A 62-year-old man presented with right homonymous hemianopsia, and magnetic resonance imaging (MRI) showed a giant thrombosed aneurysm with poor wall contrast enhancement, which indicates little involvement of the vasa vasorum, at the terminal part of the left internal carotid artery. To block blood flow into the aneurysmal dome, stent-assisted "jam-packed" coil embolization was performed. For this, a braided stent was shortened to enhance metal coverage ratio and tight aneurysmal coil packing was performed using a hydrogel coil. Our technique resulted in complete obliteration of the aneurysm, and MRI performed 1 year later showed remarkable shrinkage of the aneurysm dome. Stent-assisted jam-packed coil embolization technique might be effective in shrinking the dome of giant thrombosed aneurysms with poor wall contrast enhancement.
Sections du résumé
BACKGROUND
BACKGROUND
Large and giant aneurysms are known to involve intra-aneurysmal thrombosis and present a poor prognosis because of compression of the surrounding brain tissue with enlargement of the aneurysm. These aneurysms are difficult to cure by endovascular treatment due to involvement of the vasa vasorum in their pathology. We report this technical note to describe stent-assisted jam-packed coil embolization for the treatment of a giant thrombosed aneurysm.
CASE DESCRIPTION
METHODS
A 62-year-old man presented with right homonymous hemianopsia, and magnetic resonance imaging (MRI) showed a giant thrombosed aneurysm with poor wall contrast enhancement, which indicates little involvement of the vasa vasorum, at the terminal part of the left internal carotid artery. To block blood flow into the aneurysmal dome, stent-assisted "jam-packed" coil embolization was performed. For this, a braided stent was shortened to enhance metal coverage ratio and tight aneurysmal coil packing was performed using a hydrogel coil. Our technique resulted in complete obliteration of the aneurysm, and MRI performed 1 year later showed remarkable shrinkage of the aneurysm dome.
CONCLUSION
CONCLUSIONS
Stent-assisted jam-packed coil embolization technique might be effective in shrinking the dome of giant thrombosed aneurysms with poor wall contrast enhancement.
Identifiants
pubmed: 34345469
doi: 10.25259/SNI_511_2021
pii: 10.25259/SNI_511_2021
pmc: PMC8326107
doi:
Types de publication
Case Reports
Langues
eng
Pagination
328Informations de copyright
Copyright: © 2021 Surgical Neurology International.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
J Neuropathol Exp Neurol. 2014 Sep;73(9):855-64
pubmed: 25101705
Neurosurgery. 2017 Jan 01;80(1):40-48
pubmed: 28362885
Stroke. 1981 May-Jun;12(3):273-83
pubmed: 7245291
World Neurosurg. 2018 Oct;118:e834-e841
pubmed: 30026151
Neurosurgery. 2004 Aug;55(2):316-23; discussion 323-6
pubmed: 15271237
AJNR Am J Neuroradiol. 2010 Aug;31(7):1197-205
pubmed: 20299431
Neurosurgery. 2005 Mar;56(3):441-54; discussion 441-54
pubmed: 15730569
Neurosurgery. 2008 Nov;63(5):832-42; discussion 842-4
pubmed: 19005372
Stroke. 2009 Aug;40(8):e523-9
pubmed: 19520984
J Neurointerv Surg. 2015 Jul;7(7):524-9
pubmed: 24827067
AJNR Am J Neuroradiol. 2016 Apr;37(4):636-41
pubmed: 26564437
J Neurosurg. 2017 Jul;127(1):81-88
pubmed: 27739944
Cerebrovasc Dis. 2016;41(3-4):187-98
pubmed: 26764969
Clin Neurosurg. 1979;26:12-95
pubmed: 544122
J Neurosurg. 2019 Dec 6;134(1):49-57
pubmed: 31812141
World Neurosurg. 2020 Mar;135:e164-e173
pubmed: 31760188
Acta Neurochir (Wien). 2014 Jan;156(1):1-10
pubmed: 24249668
J Neurointerv Surg. 2018 Jan;10(1):83-87
pubmed: 28138062
Interv Neuroradiol. 2007 Jun;13(2):117-26
pubmed: 20566139
AJNR Am J Neuroradiol. 2019 Jul;40(7):1106-1111
pubmed: 31147351
Stroke. 2013 Feb;44(2):442-7
pubmed: 23321438