論文

国際誌
2022年3月

Contralateral Transradial Access for Coil Embolization of Distal Anterior Cerebral Artery Aneurysm Associated With a Steep Ipsilateral A1-A2 Angle.

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
  • Ken Yamazaki
  • ,
  • Yoshiki Hanaoka
  • ,
  • Jun-Ichi Koyama
  • ,
  • Daisuke Yamazaki
  • ,
  • Yu Fujii
  • ,
  • Toshihiro Ogiwara
  • ,
  • Tetsuyoshi Horiuchi

31
3
開始ページ
106299
終了ページ
106299
記述言語
英語
掲載種別
DOI
10.1016/j.jstrokecerebrovasdis.2021.106299

OBJECTIVE: Endovascular treatment of distal anterior cerebral artery aneurysms is commonly addressed via the ipsilateral A1 segment of the anterior cerebral artery. However, when the parent pericallosal artery has a sharp ipsilateral A1-A2 angle, catheterization through the ipsilateral A1 segment can potentially result in vessel injury, catheter kinking, and/or compromised/stagnant anterior cerebral artery flow. Here, we present a case of a distal anterior cerebral artery aneurysm associated with a steep ipsilateral A1-A2 angle treated with contralateral transradial coil embolization. CASE PRESENTATION: A 91-year-old woman presented with a ruptured left distal anterior cerebral artery aneurysm at the A3 segment. The parent pericallosal artery had a steep ipsilateral A1-A2 angle. To safely achieve coil embolization of the aneurysm, a contralateral transradial system via the right A1 segment was employed. Although a secondary ipsilateral transradial system was required for contrast injection, aneurysm obliteration was successfully achieved without vessel injury or system instability. CONCLUSION: The A1-A2 angle can be a key anatomical factor in the endovascular treatment of distal anterior cerebral artery aneurysms. The contralateral transradial system is a useful treatment option for distal anterior cerebral artery aneurysms associated with sharp ipsilateral A1-A2 angles. However, if the distal anterior cerebral artery aneurysm cannot be clearly visualized through the contralateral system, an ipsilateral system will be required for contrast injection.

リンク情報
DOI
https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106299
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/35033987
ID情報
  • DOI : 10.1016/j.jstrokecerebrovasdis.2021.106299
  • PubMed ID : 35033987

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