Flow-Diverter Stent for an Unruptured Aneurysm at the Junction of the Internal Carotid Artery and Persistent Primitive Trigeminal Artery: Case Report and Literature Review

Authors

• Hirotaka Sato, Department of Neurosurgery, Hakodate Shintoshi Hospital, Hakodate, Japan. Electronic address: kyokui080021@gmail.com.
• Koichi Haraguchi, Department of Neurosurgery, Hakodate Shintoshi Hospital, Hakodate, Japan.
• Yashuhiro Takahashi, Department of Neurosurgery, Hakodate Shintoshi Hospital, Hakodate, Japan.
• Shunya Ohtaki, Department of Neurosurgery, Hakodate Shintoshi Hospital, Hakodate, Japan.
• Tadakazu Shimizu, Department of Neurosurgery, Hakodate Shintoshi Hospital, Hakodate, Japan.
• Nobuyuki Matsuura, Department of Neurosurgery, Hakodate Shintoshi Hospital, Hakodate, Japan.
• Kazumi Ogane, Department of Neurosurgery, Hakodate Shintoshi Hospital, Hakodate, Japan.
• Takeo Ito, Department of Neurosurgery, Hakodate Shintoshi Hospital, Hakodate, Japan.

Document Type

Article

Abstract

BACKGROUND: Persistent primitive trigeminal artery (PPTA), which is a fetal carotid-basilar anastomosis, is the most common embryologic vascular remnant persisting in adults. Aneurysms can arise between the internal carotid artery (ICA) and PPTA. Here we present a case of ICA-PPTA aneurysm treated with a flow-diverter stent. CASE DESCRIPTION: A 52-year-old woman had left abducens nerve palsy. Imaging detected a large left ICA-PPTA aneurysm, which we chose to treat with a flow-diverter stent after embolizing the PPTA with a coil. Although the abducens nerve palsy did not change, there were no signs of cerebral infarction, and no new symptoms appeared postoperatively. Blood flow in the aneurysm had disappeared on digital subtraction angiography after 6 months. CONCLUSIONS: This is the first case report of ICA-PPTA aneurysm successfully treated with a flow-diverter stent. We could stop blood flow from the posterior circulation by embolizing the PPTA with a coil, allowing the use of a flow-diverter stent. This report can be used as a reference for the procedure in future work.

Keywords

Flow-diverter stent, Internal carotid artery, Persistent primitive trigeminal artery aneurysm, Selective coil embolization

Medical Subject Headings

Abducens Nerve Diseases (etiology); Basilar Artery (abnormalities, diagnostic imaging); Carotid Artery Diseases (complications, diagnostic imaging, therapy); Carotid Artery, Internal (abnormalities, diagnostic imaging); Computed Tomography Angiography; Embolization, Therapeutic (methods); Female; Humans; Imaging, Three-Dimensional; Intracranial Aneurysm (complications, diagnostic imaging, therapy); Middle Aged; Stents; Vascular Malformations (complications, diagnostic imaging, therapy)

Publication Date

12-1-2019

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

132

First Page

329

Last Page

332

PubMed ID

31493612

Digital Object Identifier (DOI)

10.1016/j.wneu.2019.08.199

Recommended Citation

Sato, Hirotaka; Haraguchi, Koichi; Takahashi, Yashuhiro; Ohtaki, Shunya; Shimizu, Tadakazu; Matsuura, Nobuyuki; Ogane, Kazumi; and Ito, Takeo, "Flow-Diverter Stent for an Unruptured Aneurysm at the Junction of the Internal Carotid Artery and Persistent Primitive Trigeminal Artery: Case Report and Literature Review" (2019). Translational Neuroscience. 2586.
https://scholar.barrowneuro.org/neurobiology/2586