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Telescoping flow diverters for a pediatric fusiform distal anterior cerebral artery aneurysm: technical case report

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Abstract

Background and importance

Pediatric intracranial aneurysms are rare, with fusiform aneurysms of the distal anterior circulation even more so. A limited number of prior reports detail the management of this pathology.

Clinical presentation

We report a case of a 15-year-old boy presenting with new-onset headache found to have a 3.1 cm × 1.4 cm × 1.4 cm fusiform partially thrombosed aneurysm of the A2 segment of the left anterior cerebral artery. Subsequent treatment with flow diversion resulted in the placement of five telescoping PEDs (2.5 mm × 20 mm, 2.75 mm × 20 mm, 2.75 mm × 20 mm, 3 mm × 25 mm, and 3 mm × 20 mm) from the left pericallosal artery to the left A1 segment. Catheter-based angiography at 6 months post-placement indicated normal vessel caliber, no residual aneurysm, and no in-stent stenosis. The patient’s headache resolved after treatment.

Conclusion

Telescoping PEDs are a feasible low-risk treatment option for long-segment fusiform distal ACA aneurysms in children that can have optimal clinical and radiographic outcomes.

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Authors and Affiliations

  1. Department of Neurological Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian, Suite B-400, 200 Lothrop St., Pittsburgh, PA, 15213, USA

    Daniel A. Tonetti, Stephanie M. Casillo & Brian T. Jankowitz

  2. Cooper Neurological Institute, Cooper University Medical Center, Camden, NJ, USA

    Brian T. Jankowitz

Authors
  1. Daniel A. Tonetti
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  2. Stephanie M. Casillo
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  3. Brian T. Jankowitz
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Correspondence to Daniel A. Tonetti.

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The authors declare that they have no conflict of interest.

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This study was approved by our local Institutional Review Board, and the patient’s family was consented for publication of the patient’s de-identified data.

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Tonetti, D.A., Casillo, S.M. & Jankowitz, B.T. Telescoping flow diverters for a pediatric fusiform distal anterior cerebral artery aneurysm: technical case report. Childs Nerv Syst 37, 999–1002 (2021). https://doi.org/10.1007/s00381-020-04797-y

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  • DOI: https://doi.org/10.1007/s00381-020-04797-y

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