Endoport-Assisted Microsurgical Treatment of a Ruptured Periventricular AneurysmReport as inadecuate




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Case Reports in Neurological Medicine - Volume 2016 2016, Article ID 8654262, 4 pages -

Case Report

Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA 22908, USA

Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA 22908, USA

Received 19 February 2016; Accepted 10 April 2016

Academic Editor: Majaz Moonis

Copyright © 2016 Ching-Jen Chen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Importance. Ruptured periventricular aneurysms in patients with moyamoya disease represent challenging pathologies. The most common methods of treatment include endovascular embolization and microsurgical clipping. However, rare cases arise in which the location and anatomy of the aneurysm make these treatment modalities particularly challenging. Clinical Presentation. We report a case of a 34-year-old female with moyamoya disease who presented with intraventricular hemorrhage. CT angiography and digital subtraction angiography revealed an aneurysm located in the wall of the atrium of the right lateral ventricle. Distal endovascular access was not possible, and embolization risked the sacrifice of arteries supplying critical brain parenchyma. Using the BrainPath endoport system, the aneurysm was able to be accessed. Since the fusiform architecture of the aneurysm prevented clip placement, the aneurysm was ligated with electrocautery. Conclusion. We demonstrate the feasibility of endoport-assisted approach for minimally invasive access and treatment of uncommon, distally located aneurysms.





Author: Ching-Jen Chen, James Caruso, Robert M. Starke, Dale Ding, Thomas Buell, R. Webster Crowley, and Kenneth C. Liu

Source: https://www.hindawi.com/



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