Techniques of reoperation for a giant regrown anterior communicating artery aneurysm harboring long-implanted clips and compacted coil mesh.
A 57-year-old woman presented with a progressive deterioration of vision. She had previously undergone clipping for a ruptured small anterior communicating artery (Acom) aneurysm 7 years prior to admission and additional coiling for recurrence 2 years prior to admission. Angiography showed regrown out-pouching of the sac, which measured 27 x 18 mm. A decision was made to perform surgical treatment to alleviate the mass effect of the aneurysm. Unique techniques for revision of the scarred surgical corridor, removal of old clips, resection of the coiled mass, thrombectomy, and intra-aneurysmal endarterectomy were required to allow placement of the final clips. The patient recovered uneventfully, and her vision was satisfactorily restored.
Kim
Yong Bae
YB
Department of Neurosurgery, Cerebrovascular Center, National Health Insurance Corporation Ilsan Hospital, Koyang, Korea.
Lee
Jae Whan
JW
Lee
Kyu Chang
KC
Choi
Yoon Jung
YJ
D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation / Q000502:physiology; D002941:Circle of Willis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods*; D009897:Optic Chiasm / Q000473:pathology / Q000503:physiopathology; D019736:Prostheses and Implants / Q000009:adverse effects; D012008:Recurrence; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D013525:Surgical Instruments / Q000009:adverse effects; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D015354:Vision, Low / Q000209:etiology