Turkish Neurosurgery 2015 , Vol 25 , Num 1
Recanalization of a Large Supraclinoid Carotid Aneurysm Via Elicited Vertebral Artery-Internal Carotid Artery Anastomosis: A Case Report
Kimihiro NAGATANI1, Nobusuke TSUZUKI2, Hiroshi KAGEYAMA2, Katsuji SHIMA1
1National Defense Medical College, Department of Neurosurgery,Tokorozawa, Saitama, Japan
2Kuki General Hospital, Department of Neurosurgery, Kuki, Saitama, Japan
DOI : 10.5137/1019-5149.JTN.8877-13.0 Proximal ligation of the internal carotid artery (ICA) with high-flow bypass is one of the surgical strategies for treating large, unclippable ICA aneurysms. We encountered a rare case of recanalization of a large ICA aneurysm that disappeared after high-flow bypass surgery, and subsequently reappeared via an elicited vertebral artery (VA)-ICA anastomosis (anastomosis between the anterior meningeal artery branching from the right VA, and the ascending pharyngeal artery branching (APA) from the right ICA). To the best of our knowledge, this is the first case report describing angiographical recurrence of a large ICA aneurysm after the surgery. Periodic long-term follow-up by neuroimaging may be necessary after this surgery, particularly in cases of ICA proximal ligation with the ICA aneurysm, when the APA has not been clearly identified as a branch from the ipsilateral external carotid artery on the preoperative angiogram. Keywords : Anterior meningeal artery, Ascending pharyngeal artery, Cerebral revascularization, Internal carotid artery occlusion, Intracranial aneurysm
Corresponding author : Kimihiro Nagatanı, naval.kimi@gmail.com