Occlusion of the Parent Artery after Wrapping of Aneurysms

概要

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We report 2 cases with occlusion of the parent artery after wrapping of cerebral aneurysm. In a 57-year-old male patient, infundibular dilatation of the posterior communicating artery was wrapped with Bemsheets (Bemlyse, 100% cotton linter) applied to the entire internal carotid artery (IC) circumferentially. Two months later, he presented with right hemiplegia and aphasia. Angiography revealed total occlusion of the IC. In another 55-year-old female patient, a left middle cerebral artery (MCA) aneurysm was clipped and the residual dome was wrapped with Bemsheets including MCA trunk, with an additional coating of fibrin glue. Disappearance of aneurysm and occlusion of the MCA was visualized on angiography two months after surgery.<BR>Although Bemsheets are one of the best wrapping materials for cerebral aneurysm, inflammatory granulation develops, causing delayed stenosis or occlusion of the parent arteries. These occlusive complications should be avoided by wrapping without including the entire parent artery.
The Japanese Society on Surgery for Cerebral Strokeの論文