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Endovascular Treatment of a Lenticulostriate Artery Aneurysm with N-butyl Cyanoacrylate

Published online by Cambridge University Press:  02 December 2014

Ramiro Larrazabal ,
David Pelz  and
J. Max Findlay
Ramiro Larrazabal
Affiliation:
Department of Diagnostic Radiology and Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
David Pelz
Affiliation:
Department of Diagnostic Radiology and Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
J. Max Findlay
Affiliation:
Division of Neurosurgery, University of Alberta, MacKenzie Health Sciences Centre, Edmonton, Alberta, Canada
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Abstract

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Background:

Aneurysms arising from lenticulostriate artery branches in moyamoya-type disease are challenging lesions to treat, due to their fragility and deep location. Surgery is difficult and endovascular options may be limited.

Methods:

A 57-year-old woman presented with a right ganglionic parenchymal hemorrhage due to a ruptured lenticulostriate artery aneurysm associated with ipsilateral middle cerebral artery occlusion. The aneurysm and parent feeding artery were occluded using endovascular injection of N-butyl cyanoacrylate.

Results:

The aneurysm was successfully obliterated and although some glue did enter the more distal middle cerebral artery, there was no change in the patient's neurologic status.

Conclusion:

In highly selected cases where lenticulostriate aneurysms cannot be directly accessed for surgery or endovascular coiling, obliteration with liquid acrylic glue may be considered as a therapeutic option.

Résumé:

RÉSUMÉ:Introduction:

Les anévrismes qui prennent naissance sur des branches de l'artère lenticulostriée dans la maladie de type moyamoya sont des lésions difficiles à traiter à cause de leur fragilité et de leur site profond. La chirurgie est difficile et les options endovasculaires limitées.

Méthodes:

Une femme âgée de 57 ans a consulté pour une hémorragie parenchymateuse ganglionaire droite due à la rupture d'un anévrisme de l'artère lenticulostriée associé à une occlusion de l'artère cérébrale moyenne ipsilatérale. L'anévrisme et l'artère nourricière ont été occlus au moyen d'une injection endovasculaire de N-butyl cyanoacrylate.

Résultats:

L'anévrisme a été oblitéré avec succès et, bien qu'un peu de colle ait pénétré dans l'artère cérébrale moyenne distale, il n'y a pas eu de changement du statut neurologique de la patiente.

Conclusions:

Dans des cas bien choisis où les anévrismes lenticulostriés sont hors d'atteinte de la chirurgie ou de la mise en place d'un serpentin par voie endovasculaire, l'oblitération par une colle acrylique liquide peut être une option thérapeutique valable.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 28 , Issue 3 , August 2001 , pp. 256 - 259
Copyright
Copyright © The Canadian Journal of Neurological 2001

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