Radical treatment of ruptured dissecting aneurysm on the P1 segment with monotherapy using multiple LVIS stents

BMJ Case Rep. 2021 Sep 14;14(9):e244950. doi: 10.1136/bcr-2021-244950.

Abstract

The standard endovascular treatment for ruptured dissecting aneurysm is a parent artery occlusion. However, this treatment is unsuitable when the artery of the lesion gives off perforating vessels that supply blood to critical regions or when the collateral flow cannot be expected due to the sacrifice of the parent artery. Here, we present an infrequent case of ruptured dissecting aneurysm on P1 segment of the posterior cerebral artery. The aneurysm had little sac for coiling and the artery of the lesion had some perforator branches; thus, we selected the monotherapy with three overlapping low-profile visualised intraluminal support stents as radical treatment, which resulted in prompt obliteration of the aneurysm. The patient was fully recovered at 3 months after the procedure. Previous studies have reported the effectiveness of multiple stents alone for dissecting aneurysms, whereas this case showed that overlapping stents may also be effective on the P1 segment.

Keywords: interventional radiology; neurosurgery.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, Ruptured* / diagnostic imaging
  • Aneurysm, Ruptured* / surgery
  • Aortic Dissection* / diagnostic imaging
  • Aortic Dissection* / surgery
  • Cerebral Angiography
  • Embolization, Therapeutic*
  • Endovascular Procedures*
  • Humans
  • Intracranial Aneurysm* / diagnostic imaging
  • Intracranial Aneurysm* / surgery
  • Retrospective Studies
  • Stents
  • Treatment Outcome