title: Endovascular treatment of intracranial aneurysms in Loeys-Dietz syndrome.
abstract: BACKGROUND
  Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder characterized by extensive arterial aneurysms. The successful clipping of intracranial aneurysms in patients with LDS has been reported in a limited number of patients but endovascular treatment of intracranial aneurysms in LDS has never before been described. The first successful cases of endovascular management of five intracranial aneurysms in two patients with LDS are reported.
  
  
  METHODS
  The first patient was an asymptomatic 45-year-old woman with LDS and two incidentally discovered, unruptured wide necked aneurysms (6×5 mm and 4×2 mm) arising from the ophthalmic segment of the left internal carotid artery. Both aneurysms were successfully embolized via Neuroform stent assisted coiling. The second patient was an asymptomatic middle 40s woman with LDS found to have an unruptured anterior communicating artery aneurysm (7×4 mm) as well as two ophthalmic segment aneurysms (2.5×3.7 mm and 2.9×3.5 mm). All three aneurysms were successfully embolized via Neuroform stent assisted coiling in two staged procedures. There were no periprocedural complications in either patient. Long term follow-up imaging demonstrated durable embolization in all aneurysms in both patients.
  
  
  CONCLUSIONS
  This is the first reported case series of endovascular management of intracranial aneurysms in the setting of LDS. The endovascular approach was safe, effective and durable in all aneurysms in both patients, and should be considered when treating patients with LDS and intracranial aneurysms.
authors.affiliation: Neurological Surgery, University of Washington, Seattle, Washington 98104, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Levitt
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Morton
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Mai
authors.forename: Basavaraj
authors.initials: B
authors.lastname: Ghodke
authors.forename: Danial K
authors.initials: DK
authors.lastname: Hallam
mesh_terms: D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D055947:Loeys-Dietz Syndrome / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008875:Middle Aged; D016896:Treatment Outcome