Delayed Thromboembolic Events 9 Weeks after Endovascular Treatment of an Anterior Communicating Artery Aneurysm: Case Report
Matthew T. Studleya,
David H. Robinsona and
John F. Howeb
a Department of Radiology, Neurosurgery Department, Seattle, WA
b Department of Virginia Mason Medical Center, and Group Health Central, Neurosurgery Department, Seattle, WA
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FIG 1. CT angiograms obtained to further define aneurysm anatomy in the case of a 54-year-old man.
A, Water’s projection with 3D reconstruction shows a 11 x 7 mm anterior communicating artery aneurysm (arrow).
B, Lateral view shows a lobulated anterior communicating artery aneurysm (solid arrow) with a 4-mm neck (open arrow).
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FIG 2. Preoperative injection of the left internal carotid artery shows the anterior communicating artery aneurysm (straight arrow) with cross filling of the right anterior cerebral artery (curved arrow).
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FIG 3. Postoperative angiograms showed total occlusion of the aneurysm sac, with no residual contrast material filling of the aneurysm sac or neck.
A, Magnified postoperative anteroposterior angiogram shows the densely packed aneurysm sac (straight arrow). No coils extend into the well-visualized aneurysm neck (curved arrow).
B, Subtracted postoperative anteroposterior angiogram shows no residual blood flow in the aneurysm sac (solid arrow). Cross filling of the anterior cerebral artery (curved arrow) can be seen.
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FIG 4. Axial diffusion-weighted MR images obtained 9 weeks after endovascular treatment.
A and B, Multiple regions of high signal intensity are depicted bilaterally in the distribution of the anterior communicating arteries, consistent with acute embolic infarcts.
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