Dissecting aneurysm of the extracranial vertebral artery after endovascular surgery.
A 43-year-old man with a scalp arteriovenous fistula developed cerebellar and pontine infarctions after an endovascular procedure. Nine months after the procedure, the patient experienced transient loss of consciousness. A fusiform dilatation of the left vertebral artery at the level of the atlas was found on angiography. The lesion was excised and a saphenous vein graft was interposed. Histological examination of the resected specimen revealed a dissecting aneurysm. This may have been precipitated by subintimal passage of the guide wire/catheter at the time of his endovascular surgery or by chemical damage to the arterial wall from embolic material.
Fukao
S
S
Department of Neurosurgery, National Cardiovascular Center, Osaka, Japan.
Hashimoto
N
N
Kazekawa
K
K
Yonekawa
Y
Y