PMID- 37501897
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230729
IS  - 2186-2494 (Electronic)
IS  - 1882-4072 (Print)
IS  - 1882-4072 (Linking)
VI  - 16
IP  - 6
DP  - 2022
TI  - Bleb Embolization of Ruptured Cerebral Aneurysms with Coils and n-Butyl 
      Cyanoacrylate Following Proximal Flow Control: Two Case Reports.
PG  - 313-319
LID - 10.5797/jnet.cr.2021-0082 [doi]
AB  - OBJECTIVE: Morphologically challenging cerebral aneurysms cannot be treated 
      through standard endovascular procedures. We report two cases of ruptured 
      aneurysms treated using coils and n-butyl cyanoacrylate (NBCA). CASE 
      PRESENTATIONS: Case 1 was an 80-year-old woman diagnosed with a subarachnoid 
      hemorrhage (SAH). An angiogram revealed a large and wide-necked basilar artery 
      bifurcation aneurysm. Bilateral superior cerebellar and posterior cerebral 
      arteries (PCAs) originated from the aneurysmal wall. A 3-mm-diameter bleb was 
      detected on the aneurysmal fundus. The bleb enlarged 1 month following coil 
      insertion. During the second treatment, we infused a small volume of 33% NBCA 
      into the coil-framed bleb following proximal flow control of the bilateral 
      vertebral arteries (VAs). The complete bleb obliteration was confirmed by the 
      angiogram at 6 months later. The coil shape was followed up via plane X-ray for 5 
      years. No rebleeding occurred. Case 2 was a 41-year-old woman diagnosed with SAH. 
      An angiogram revealed a dissecting aneurysm of the left PCA (P1 and P2 segments) 
      accompanying a bleb on the P1 segment. Endovascular treatment was performed, and 
      a coil was inserted into the bleb, infusing 33% NBCA into the coil frame 
      following proximal flow control of bilateral VAs and the right internal carotid 
      artery. Angiograms conducted at 3 months, 1 year, and 9 years and an MRA 
      conducted 12 years later revealed a lack of bleb recanalization. CONCLUSION: We 
      developed a Coil and NBCA technique to obliterate ruptured blebs following 
      proximal flow control. This technique can be considered an effective alternative 
      for treating morphologically challenging cerebral aneurysms.
CI  - (c)2022 The Japanese Society for Neuroendovascular Therapy.
FAU - Tone, Osamu
AU  - Tone O
AD  - Stroke Center, Ome Municipal General Hospital, Ome, Tokyo, Japan.
FAU - Sato, Yohei
AU  - Sato Y
AD  - Department of Neurosurgery, Japanese Red Cross Musashino Hospital, Musashino, 
      Tokyo, Japan.
FAU - Tamaki, Masashi
AU  - Tamaki M
AD  - Department of Neurosurgery, Japanese Red Cross Musashino Hospital, Musashino, 
      Tokyo, Japan.
FAU - Takada, Yoshiaki
AU  - Takada Y
AD  - Department of Neurosurgery, Ome Municipal General Hospital, Ome, Tokyo, Japan.
LA  - eng
PT  - Case Reports
DEP - 20211001
PL  - Japan
TA  - J Neuroendovasc Ther
JT  - Journal of neuroendovascular therapy
JID - 101488164
PMC - PMC10370545
OTO - NOTNLM
OT  - balloon occlusion
OT  - basilar artery
OT  - endovascular technique
OT  - posterior cerebral artery
OT  - subarachnoid hemorrhage
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2022/01/01 00:00
MHDA- 2022/01/01 00:01
PMCR- 2022/01/01
CRDT- 2023/07/28 04:07
PHST- 2021/07/02 00:00 [received]
PHST- 2021/08/14 00:00 [accepted]
PHST- 2022/01/01 00:01 [medline]
PHST- 2022/01/01 00:00 [pubmed]
PHST- 2023/07/28 04:07 [entrez]
PHST- 2022/01/01 00:00 [pmc-release]
AID - jnet.cr.2021-0082 [pii]
AID - 10.5797/jnet.cr.2021-0082 [doi]
PST - ppublish
SO  - J Neuroendovasc Ther. 2022;16(6):313-319. doi: 10.5797/jnet.cr.2021-0082. Epub 
      2021 Oct 1.