Gómez-Amador JL, Tovar-Romero LA, Castillo-Matus A, Marian-Magaña R, Aragón-Arreola JF, Sangrador-Deitos MV, Hernández-Hernández A, López-Valencia G, Guinto-Nishimura GY, Ríos-Zermeño J. Intra-aneurysmatic thrombectomy in a distal anterior cerebral artery aneurysm.
J Cerebrovasc Endovasc Neurosurg 2023;
25:462-467. [PMID:
38192188 PMCID:
PMC10774688 DOI:
10.7461/jcen.2023.e2023.01.002]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 01/10/2024] Open
Abstract
Thrombectomy procedures following intra-aneurysmatic lesions are extremely rare, and few cases have been reported. This article describes a microsurgical intra-aneurysmatic thrombectomy (MIaT) for a distal anterior cerebral artery (DACA) aneurysm. We present the case of a 48-year-old female that was admitted to the emergency room, showing neurologic deterioration with focal deficits. A computed tomography angiography (CTA) scan revealed an aneurysm located in the distal segment of the left anterior cerebral artery. During the surgical procedure, after clipping, a wellformed clot was visualized through the aneurysm's wall obstructing the left DACA flow. We proceeded to open the aneurysm's dome to remove the thrombus and clip the aneurysm neck, re-establishing the flow of the left DACA. Intra-aneurysmatic thrombosis can occur as a complication during clipping, obstructing the distal flow of vital arteries and causing fatal results in the patient's postoperative status. MIaT is a good technique for restoring the flow of the affected vessel and allows a secure aneurysm clipping after thrombus removal.
Collapse