Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
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Intra-aneurysmatic thrombectomy in a distal anterior cerebral artery aneurysm

  • Juan Luis Gomez-Amador (Department of Neurosurgery, National Institute of Neurology and Neurosurgery) ;
  • Leoncio Alberto Tovar-Romero (Department of Neurosurgery, National Institute of Neurology and Neurosurgery) ;
  • Andrea Castillo-Matus (Department of Neurosurgery, National Institute of Neurology and Neurosurgery) ;
  • Ricardo Marian-Magana (Department of Neurosurgery, National Institute of Neurology and Neurosurgery) ;
  • Jorge Fernando Aragon-Arreola (Department of Neurosurgery, National Institute of Neurology and Neurosurgery) ;
  • Marcos Vinicius Sangrador-Deitos (Department of Neurosurgery, National Institute of Neurology and Neurosurgery) ;
  • Alan Hernandez-Hernandez (Department of Neurosurgery, National Institute of Neurology and Neurosurgery) ;
  • German Lopez-Valencia (Department of Neurosurgery, National Institute of Neurology and Neurosurgery) ;
  • Gerardo Yoshiaki Guinto-Nishimura (Department of Neurosurgery, National Institute of Neurology and Neurosurgery) ;
  • Jorge Rios-Zermeno (Department of Neurosurgery, National Institute of Neurology and Neurosurgery)
  • Received : 2023.01.19
  • Accepted : 2023.04.20
  • Published : 2023.12.31
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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 well-formed 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.

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References

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