Thromboembolic complication induced stable occlusion of a ruptured basilar tip aneurysm. Case report and review of the literature.
We describe a case of a ruptured basilar bifurcation aneurysm that thrombosed during preparation for endovascular therapy as a complication of diagnostic angiogaphy, and showed a favorable evolution during long-term follow-up. Endogenous thrombosis of ruptured, non giant aneurysms is uncommon. The persistence of occlusion over time in such cases is not well established. Two weeks after rupture, a 6 x 8 mm basilar bifurcation aneurysm was referred for endovascular treatment. During preparation for endovascular coil occlusion, without having any endovascular material at the level of the basilar artery, a complete thrombotic occlusion of the basilar bifurcation and aneurysm was observed. Given the good collateral circulation for both posterior cerebral arteries no thrombolysis was undertaken. The early follow-up of seven days, three and six months showed a complete recanalization of the basilar artery and remodeling of the basilar bifurcation. The 20 months imaging follow-up demonstrated a small aneurysm regrowth at the prevoius location that remained stable during the follow-up of seven years. Unchanged biological and hemodynamic characteristics. however, may pose an elevated risk of a new aneurysm formation over time, making long-term imaging follow-up, and in case of progression, aneurysm occlusion necessary for the patient.
Kulcsár
Z
Z
Neuroradiology Department, Klinik Hirslanden; Zurich, Switzerland. kulcsarzsolt22@gmail.com
Berentei
Z
Z
Marosföi
M
M
Vajda
J
J
Szikora
I
I
D017542:Aneurysm, Ruptured / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D008875:Middle Aged; D011859:Radiography; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000209:etiology*; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology*