1.Intra-aneurysmatic thrombectomy in a distal anterior cerebral artery aneurysm
Juan Luis GÓMEZ-AMADOR ; Leoncio Alberto TOVAR-ROMERO ; Andrea CASTILLO-MATUS ; Ricardo MARIAN-MAGAÑA ; Jorge Fernando ARAGÓN-ARREOLA ; Marcos Vinicius SANGRADOR-DEITOS ; Alan HERNÁNDEZ-HERNÁNDEZ ; Germán LÓPEZ-VALENCIA ; Gerardo Yoshiaki GUINTO-NISHIMURA ; Jorge RÍOS-ZERMEÑO
Journal of Cerebrovascular and Endovascular Neurosurgery 2023;25(4):462-467
Thrombectomy procedures following intra-aneurysmatic lesions are extremely rare, and few cases have been reported. This article describes a microsurgical intra-aneurysmatic thrombectomy (MIaT) for a distal anterior cerebral artery (DACA) aneurysm. We present the case of a 48-year-old female that was admitted to the emergency room, showing neurologic deterioration with focal deficits. A computed tomography angiography (CTA) scan revealed an aneurysm located in the distal segment of the left anterior cerebral artery. During the surgical procedure, after clipping, a wellformed clot was visualized through the aneurysm’s wall obstructing the left DACA flow. We proceeded to open the aneurysm’s dome to remove the thrombus and clip the aneurysm neck, re-establishing the flow of the left DACA.Intra-aneurysmatic thrombosis can occur as a complication during clipping, obstructing the distal flow of vital arteries and causing fatal results in the patient’s postoperative status. MIaT is a good technique for restoring the flow of the affected vessel and allows a secure aneurysm clipping after thrombus removal.
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