J Korean Neurosurg Soc.  2010 May;47(5):406-408. 10.3340/jkns.2010.47.5.406.

Stent-Assisted Coil Embolization for the Proximal Middle Cerebral Artery Fusiform Aneurysm

• Jeong SM
• Kang SH
• Lee NJ
• Lim DJ

• KMID: 2066785
• DOI: http://doi.org/10.3340/jkns.2010.47.5.406

Abstract

Middle cerebral artery (MCA) fusiform aneurysms often have an unfavorable geometry that may limit surgical or endovascular treatment. Herein, we present a case of a fusiform aneurysm of the proximal MCA, which was successfully treated using stent-assisted coil embolization. A 42-year-old man presented with repeated headache and syncope. Five years earlier, a right MCA aneurysm had been treated by aneurismal wrapping. Magnetic resonance images (MRI) revealed a partially-thrombosed proximal MCA aneurysm at the right perisylvian region. Digital subtraction angiography (DSA) revealed a multilobulated fusiform-shaped aneurysm. The patient underwent stent-assisted coil embolization under general anesthesia and symptoms resolved postoperatively. A three-month follow-up angiography revealed no recanalization of the aneurysm and indicated tolerable blood flow through the right MCA, as compared to the preoperative angiography. We suggest that in selected patients, stent-assisted coil embolization of proximal MCA fusiform aneurysms can be an effective treatment modality.

Keyword

Middle cerebral artery; Fusiform aneurysm; Therapeutic embolization; Stent

MeSH Terms

Adult
Anesthesia, General
Aneurysm
Angiography
Angiography, Digital Subtraction
Embolization, Therapeutic
Follow-Up Studies
Headache
Humans
Magnetic Resonance Spectroscopy
Middle Cerebral Artery
Stents
Syncope