BACKGROUND: Rupture of infectious intracranial aneurysms (IIAs) is associated with a high likelihood of mortality. Endovascular treatment of IIAs via parent artery sacrifice offers good efficacy and outcomes; however, depending on the lesion's location, neurologic deficit may result. CASE DESCRIPTION: We describe a pediatric patient with ruptured IIAs off the left middle cerebral artery (MCA) treated with coil embolization and endovascular flow diversion using the Pipeline Flex Embolization Device (PED) with Shield technology. We chose to place a flow diverter because 1) there was a second, more distal IIA not amenable to direct coil embolization, 2) there was significant potential for aneurysm regrowth and need for retreatment, and 3) we believed the diseased parent MCA needed to be reconstructed. CONCLUSIONS: In the setting of previous hemicraniectomy, PED-Shield gave us the option to discontinue dual antiplatelet therapy should the patient require further neurosurgical intervention. Our case supports a role for PED-Shield to address ruptured pseudoaneurysms.
BACKGROUND: Rupture of infectious intracranial aneurysms (IIAs) is associated with a high likelihood of mortality. Endovascular treatment of IIAs via parent artery sacrifice offers good efficacy and outcomes; however, depending on the lesion's location, neurologic deficit may result. CASE DESCRIPTION: We describe a pediatric patient with ruptured IIAs off the left middle cerebral artery (MCA) treated with coil embolization and endovascular flow diversion using the Pipeline Flex Embolization Device (PED) with Shield technology. We chose to place a flow diverter because 1) there was a second, more distal IIA not amenable to direct coil embolization, 2) there was significant potential for aneurysm regrowth and need for retreatment, and 3) we believed the diseased parent MCA needed to be reconstructed. CONCLUSIONS: In the setting of previous hemicraniectomy, PED-Shield gave us the option to discontinue dual antiplatelet therapy should the patient require further neurosurgical intervention. Our case supports a role for PED-Shield to address ruptured pseudoaneurysms.
Authors: Daniel K Han; Rami O Tadros; Christine Chung; Aman Patel; Michael L Marin; Peter L Faries Journal: Vasc Endovascular Surg Date: 2016-02-18 Impact factor: 1.089
Authors: Ramon Navarro; Benjamin L Brown; Alexandra Beier; Nathan Ranalli; Philipp Aldana; Ricardo A Hanel Journal: J Neurosurg Pediatr Date: 2015-01-02 Impact factor: 2.375
Authors: Ramesh Grandhi; Nathan T Zwagerman; Guillermo Linares; Edward A Monaco; Tudor Jovin; Michael Horowitz; Brian T Jankowitz Journal: J Neurointerv Surg Date: 2013-05-04 Impact factor: 5.836
Authors: Gaurav Girdhar; Arielle Andersen; Elizabeth Pangerl; Reza Jahanbekam; Samantha Ubl; Kevin Nguyen; John Wainwright; Michael F Wolf Journal: J Biomed Mater Res A Date: 2018-09-22 Impact factor: 4.396