Republished: Successful treatment of ruptured multiple fusiform middle cerebral artery aneurysms with silk vista baby flow diverter in a 10-months-old infant.
Giovanni BarchettiLoris Di ClementeMauro MazzettoMariano ZanussoPaola FerrareseGiuseppe IannucciPublished in: Journal of neurointerventional surgery (2021)
We report the successful treatment of multiple ruptured fusiform middle cerebral artery (MCA) aneurysms in a 10-month-old girl. This previously healthy infant presented with subarachnoid haemorrhage and was found to have multiple irregular dilatations of the superior division branch of the right MCA. Cerebral angiography was performed and confirmed the presence of multiple fusiform aneurysms of the MCA. After multidisciplinary team discussion, it was decided to treat the aneurysms with endovascular approach, using a flow-diverter. Microsurgical clipping was deemed risky because of the high likelihood of parent artery occlusion and expectant management was also considered inappropriate because of the risk of re-bleeding. Dual antiplatelet therapy was started, and a flow-diverter was successfully delivered in the superior division branch of the right MCA. The post-operative course was uneventful, MRI at 12 months did not show any sign of recurrence and at 3 years of age the patient had a normal neurological examination.
Keyphrases
- internal carotid artery
- middle cerebral artery
- antiplatelet therapy
- subarachnoid hemorrhage
- acute coronary syndrome
- percutaneous coronary intervention
- magnetic resonance imaging
- computed tomography
- palliative care
- atrial fibrillation
- quality improvement
- case report
- coronary artery disease
- magnetic resonance
- cerebral ischemia
- contrast enhanced
- brain injury
- free survival
- blood brain barrier