Dev vertebrobaziler bileşke anevrizmasının endovasküler koil ile embolizasyonunda radyolojik takip

Amaç: Bu yazıda endovasküler koil ile tedavi edilmiş dev, geniş boyunlu vertebrobaziler anevrizmanın embolizasyon sonrası uzun dönem takibinin önemini belirttik. Olgu sunumu: 52 yaşında erkek hasta, 2 yıldır baş ağrısı, 2 haftadır sağ tarafında ilerleyici kuvvet kaybı ile kliniğimize başvurdu. Serebral anjiografide, vertebrobaziler bileşkede parsiyel, tromboze olmuş, dev bir anevrizma tespit edildi. Anevrizma, hidrojel kaplı koil ile başarıyla embolize edildi. Embolizasyonun ertesi günü hastanın baş ağrısı yakınması geçti.16 ay yakınması olmayan hasta tekrar baş ağrısı şikayeti ile kliniğimize başvurdu. Vertebrobaziler anjiografide eski anevrizma boyun bölgesinin hemen yakınında yeni küçük bir anevrizma tespit edildi. Sonuç: Her ne kadar ilk yapılan işlemde dev vertebrobaziler anevrizma başarılı olarak dolaşım dışında bırakılmış gibi görünse de, koil embolizasyon takibinin en az 1.5-2 yıl yapılması gerekir.

Radiologic follow up of a giant vertebrobasilar junction aneurysm which is treated with endovascular coil embolization

Objective: In this paperwe emphasized the importance of long term follow-up of a giant wide–necked aneurysm which is treated by using endovascular detectable coils. Case report: A 52 years old male admitted to our clinic with a two years headache and progressive right sided hemiparesis which is existed within two weeks. Cerebral angiography showed a partially thrombosed giant aneurysm at the vertebrobasilar junction. The aneurysm embolized by using detachable and hydrogel coated coil successfully. The patient was symptom free on next day of embolization and within 16 months. Subsequently the patient revealed headache once more. Vertebrobasiler angiography showed a new baby aneurysm formation nearby to the neck of initial aneurysm. Conclusion: However giant vertebrobasilar junction aneurysm seems to be successfully blocked off using a detachable and hydrogel coated coils initially, at least about 1,5 and 2 years, long- term follow-up is required.

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  • 1. Saglam S, Akan H, Çekirge S, Belet U. Embolization of a giant basilar tip aneurysm by “guglielmi” detachable coils. Turk J Diagn Interv Radiol 2001;7:242-4.
  • 2. Uda K, Murayama Y, Gobin YP, Duckwiler GR, Vinuela F. Endovascular treatment of basilar artery trunk aneurysms with Guglielmi detachable coils: Clinical experience with 41 aneurysms in 39 patients. J Neurosurg 2001;95:624-32.
  • 3. Kwon OK, Kim SH, Kwon BJ, Kang HS, Kim JH, Oh CW, et al. Endovascular treatment of wide-necked aneurysms by using two microcatheters: techniques and outcomes in 25 patients. AJNR Am J Neuroradiol 2005;26:894-900.
  • 4. Ganti SR, Steinberger A, McMurtry JG 3rd, Hilal SK. Computed tomographic demonstration of giant aneurysms of the vertebrobasilar system: report of eight cases. Neurosurgery 1981;9:261-7.
  • 5. Phatouros CC, Sasaki TY, Higashida RT, Malek AM, Meyers PM, Dowd CF, et al. Stent-supported coil embolization: the treatment of fusiform and wide-neck aneurysms and pseudoaneurysms. Neurosurgery 2000;47:107-13.
  • 6. Casasco A, Arnaud O, Gobin P, Aymard A, George B, Cophignon J, et al. Giant intracranial aneurysm. Elective endovascular treatment using metallic coils. Neurochirurgie 1992;38:18-26.
  • 7. Malisch TW, Guglielmi G, Vinuela F, Duckwiler G, Gobin YP, Martin NA, et al. Intracranial aneurysms treated with the Guglielmi detachable coil: Midterm clinical results in a consecutive series of 100 patients. J Neurosurg 1997;87:176-83.
  • 8. Neschis DG, Costanza MJ, Flinn WR. Exteriorization and control of a retained embolization coil in the carotid artery. Vasc Endovascular Surg 2005;39:195-8.
  • 9. Islak C, Kantarci F. Vertebrobasilar junction aneurysms associated fenestration: Experience of five cases treated with Guglielmi detachable coils. Surg Neurol 2004;61:248-54.
  • 10. Men S, Öztürk MH, Fırat MM, Çekirge S, Seçkin H, Acıduman H, et al. Endovascular treatment of intracranial aneurysms. J Turkish Neurosurg 2003;13:26-34.
Genel Tıp Dergisi-Cover
  • ISSN: 2602-3741
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 1997
  • Yayıncı: SELÇUK ÜNİVERSİTESİ > TIP FAKÜLTESİ