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Ruptured Fusiform Aneurysm of the Anterior Spinal Artery

Successful Treatment with Flow Diverter Stent Placed in the Feeding Vertebral Artery
  • C. P. Simon-Gabriel
  • H. Urbach
  • S. Meckel
Correspondence
  • 59 Downloads

Introduction

Reports of anterior spinal artery (ASA) aneurysms are sparse in the English literature with only 10 cases of angiographically confirmed ruptured craniocervical ASA aneurysms (Table  1; [ 1, 2, 3, 4, 5, 6, 7, 8, 9, 10]). In this location they usually present with symptoms of intracranial subarachnoid hemorrhage (SAH). There is no general consensus on the optimal treatment strategy of ASA aneurysms. Management carries a significant risk and different strategies (e.g. surgical trapping, resection, endovascular occlusion and conservative wait and see) have been proposed in case reports or mini-series [ 5, 6, 10]. Flow diverter stents (FDS) are usually used for treatment of large or giant wide-necked sidewall or fusiform aneurysms where the aneurysm is directly covered by the FDS. Here, we describe the successful endovascular treatment of a ruptured fusiform ASA aneurysm by hemodynamic remodeling with a FDS placed in the ipsilateral vertebral artery (VA).
Table 1

Summary of...

Notes

Compliance with ethical guidelines

Conflict of interest

C. P. Simon-Gabriel has no conflicts of interest to declare. H. Urbach received honoraria for lectures from Bayer, Bracco, Stryker, UCB pharma. S. Meckel reports personal fees from Acandis GmbH & Co. KG/Germany during the course of the study; personal fees from Covidien Medtronic, Stryker and Microvention outside the submitted work.

Ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors. Written informed consent for publication of this case report was obtained from the patient.

References

  1. 1.
    Vincent FM. Anterior spinal artery aneurysm presenting as a subarachnoid hemorrhage. Stroke. 1981;12:230–2.CrossRefPubMedGoogle Scholar
  2. 2.
    Kawamura S, Yoshida T, Nonoyama Y, Yamada M, Suzuki A, Yasui N. Ruptured anterior spinal artery aneurysm: a case report. Surg Neurol. 1999;51:608–12.CrossRefPubMedGoogle Scholar
  3. 3.
    Jiarakongmun P, Chewit P, Pongpech S. Ruptured anterior spinal artery aneurysm associated with coarctation of aorta: case report and literature review. Interv Neuroradiol. 2002;8:285–92.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Pollock JM, Powers AK, Stevens EA, Sanghvi AN, Wilson JA, Morris PP. Ruptured anterior spinal artery aneurysm: a case report. J Neuroimaging. 2009;19:277–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Karakama J, Nakagawa K, Maehara T, Ohno K. Subarachnoid hemorrhage caused by a ruptured anterior spinal artery aneurysm. Neurol Med Chir (Tokyo). 2010;50:1015–9.CrossRefGoogle Scholar
  6. 6.
    Pahl F, de Oliveira M, Rotta MA, Dias GS, Rezende A, Rotta J. Spontaneous resolution of an isolated cervical anterior spinal artery aneurysm after subarachnoid hemorrhage. Surg Neurol Int. 2014;5:139.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Nakagawa I, Park HS, Hironaka Y, Wada T, Kichikawa K, Nakase H. Cervical spinal epidural arteriovenous fistula with coexisting spinal anterior spinal artery aneurysm presenting as subarachnoid hemorrhage—case report. J Stroke Cerebrovasc Dis. 2014;23:e461–5.CrossRefPubMedGoogle Scholar
  8. 8.
    Ashour R, Filippidis A, Patel N. Ruptured anterior spinal artery aneurysm associated with bilateral vertebral artery occlusion treated by surgical clipping. World Neurosurg. 2015;84:1178.e11–3.CrossRefGoogle Scholar
  9. 9.
    Nakhla J, Nasser R, Yassari R, Pasquale D, Altschul D. Ruptured anterior spinal artery aneurysm from a herniated cervical disc. A case report and review of the literature. Surg Neurol Int. 2016;7:10.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Dabus G, Tosello RT, Pereira BJA, Linfante I, Piske RL. Dissecting spinal aneurysms: conservative management as a therapeutic option. J Neurointerv Surg. 2017 Dec 6. [Epub ahead of print]Google Scholar
  11. 11.
    Iosif C, Mounayer C, Yavuz K, Saleme S, Geyik S, Cekirge HS, Saatci I. Middle cerebral artery bifurcation aneurysms treated by extrasaccular flow diverters: midterm angiographic evolution and clinical outcome. AJNR Am J Neuroradiol. 2017;38:310–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Marosfoi M, Clarencon F, Langan ET, King RM, Brooks OW, Tamura T, Wainwright JM, Gounis MJ, Vedantham S, Puri AS. Acute thrombus formation on phosphorilcholine surface modified flow diverters. J Neurointerv Surg. 2018;10:406–11.PubMedCentralGoogle Scholar
  13. 13.
    Chiu AH, Ramesh R, Wenderoth J, Davies M, Cheung A. Use of aspirin as sole oral antiplatelet therapy in acute flow diversion for ruptured dissecting aneurysms. J Neurointerv Surg. 2017;9:e18.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neuroradiology, Medical CenterUniversity of FreiburgFreiburgGermany

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