title: Endoport-Assisted Microsurgical Treatment of a Ruptured Periventricular Aneurysm.
abstract: Background and Importance. Ruptured periventricular aneurysms in patients with moyamoya disease represent challenging pathologies. The most common methods of treatment include endovascular embolization and microsurgical clipping. However, rare cases arise in which the location and anatomy of the aneurysm make these treatment modalities particularly challenging. Clinical Presentation. We report a case of a 34-year-old female with moyamoya disease who presented with intraventricular hemorrhage. CT angiography and digital subtraction angiography revealed an aneurysm located in the wall of the atrium of the right lateral ventricle. Distal endovascular access was not possible, and embolization risked the sacrifice of arteries supplying critical brain parenchyma. Using the BrainPath endoport system, the aneurysm was able to be accessed. Since the fusiform architecture of the aneurysm prevented clip placement, the aneurysm was ligated with electrocautery. Conclusion. We demonstrate the feasibility of endoport-assisted approach for minimally invasive access and treatment of uncommon, distally located aneurysms.
authors.affiliation: Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA 22908, USA.
authors.forename: Ching-Jen
authors.initials: CJ
authors.lastname: Chen
authors.affiliation: Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA 22908, USA.
authors.forename: James
authors.initials: J
authors.lastname: Caruso
authors.affiliation: Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA 22908, USA.
authors.forename: Robert M
authors.identifier: 0000-0002-7608-0460
authors.initials: RM
authors.lastname: Starke
authors.affiliation: Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA 22908, USA.
authors.forename: Dale
authors.identifier: 0000-0002-2627-446X
authors.initials: D
authors.lastname: Ding
authors.affiliation: Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA 22908, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Buell
authors.affiliation: Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA 22908, USA; Department of Radiology & Medical Imaging, University of Virginia Health System, Charlottesville, VA 22908, USA.
authors.forename: R Webster
authors.initials: RW
authors.lastname: Crowley
authors.affiliation: Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA 22908, USA; Department of Radiology & Medical Imaging, University of Virginia Health System, Charlottesville, VA 22908, USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Liu