Intentional Neck Plasty for Preservation of Perforating Arteries followed by Coil Embolization for Basilar Tip Aneurysm

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  • 脳底動脈先端部動脈瘤に対する穿通枝温存のための意図的頸部形成後に塞栓術を行った1例

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A 73-year-old woman underwent a frontotemporal craniotomy and aneurysmal clipping for both an unruptured internal carotid-posterior communicating aneurysm (ICPC AN) and a basilar tip aneurysm (BA tip AN). The ICPC AN was completely clipped whereas the BA tip AN was not because of kinking of the perforating arteries due to neck clipping. As the perforating arteries were tightly adherent to the aneurysm body, intentional neck plasty was achieved to spare the perforating arteries. Subsequently, obliteration of the residual BA tip AN was performed by endovascular treatment. The patient was discharged with mild oculomotor nerve palsy. Combined open and endovascular surgery for complete obliteration of the wide neck BA tip AN could be one option for preserving thalamoperforating arteries.

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