Antegrade recanalization of completely embolized internal carotid artery after treatment of a giant intracavernous aneurysm: a case report.
BACKGROUND
Parent artery occlusion is one of the traditional methods of treatment for unclippable aneurysms. However, parent artery occlusion may not result in permanent exclusion of the aneurysm from the systemic circulation. We present a case of cerebral aneurysm treated by proximal embolization of the parent artery, which recanalized during the follow-up period.


METHODS
A 69-year-old woman presented with a right blepharoptosis and diplopia. A large aneurysm arising from the cavernous portion of the right internal carotid artery was found and endovascularly excluded from the cerebral circulation by proximal internal carotid artery occlusion with balloons. Eleven days after treatment, occlusion of the parent artery and obliteration of the aneurysm were angiographically confirmed. However, the parent artery was found to be recanalized with nearly total obliteration of the aneurysm at the follow-up 6 months after treatment.


CONCLUSIONS
Angiography suggested that recanalization took place through the vaso vasorum. We believe that recanalization was induced by marginal cerebral blood flow in the ipsilateral hemisphere.
Numagami
Y
Y
Department of Neurosurgery, Tohoku University, Sendai, Japan.
Ezura
M
M
Takahashi
A
A
Yoshimoto
T
T
D000368:Aged; D002343:Carotid Artery, Internal / Q000473:pathology; D002426:Cavernous Sinus / Q000473:pathology; D003952:Diagnostic Imaging; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000628:therapy*; D012008:Recurrence; D014651:Vasa Vasorum / Q000473:pathology