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J Neurol Surg A Cent Eur Neurosurg 2023; 84(06): 593-599
DOI: 10.1055/s-0041-1739212
Case Report

Treatment of Unique Bilateral Distal Fusiform Superior Cerebellar Artery Aneurysms with Mini-Flow Diverter Device Implantation: Case Report

Björn B. Hofmann 
1   Department of Neurosurgery, Heinrich-Heine University Medical Center, Düsseldorf, Germany
,
Christian Rubbert
2   Institute of Diagnostic and Interventional Radiology, Heinrich-Heine University Medical Center, Düsseldorf, Germany
,
Bernd Turowski
2   Institute of Diagnostic and Interventional Radiology, Heinrich-Heine University Medical Center, Düsseldorf, Germany
,
Daniel Hänggi
1   Department of Neurosurgery, Heinrich-Heine University Medical Center, Düsseldorf, Germany
,
Sajjad Muhammad
1   Department of Neurosurgery, Heinrich-Heine University Medical Center, Düsseldorf, Germany
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Abstract

Currently, surgical revascularization procedures using intracranial–intracranial (IC-IC) or extracranial–intracranial (EC-IC) bypass and distal clipping or trapping are the valid and rescue treatment modality for extremely rare unilateral distal fusiform superior cerebellar artery (SCA) aneurysms. Yet, in case of bilateral fusiform SCA aneurysms, surgical therapy reaches its limit. Mini-flow diverter devices (FDDs) have only recently become available for treating fusiform aneurysms of such small vessels. We report the unique case of bilateral distal fusiform SCA aneurysms in a 43-year-old man with subarachnoid hemorrhage (Fisher grade IV and World Federation of Neurosurgical Societies [WFNS] grade II) treated with endovascular implantation of bilateral mini-FDDs with excellent outcome and no radiographic signs of infarction. Yet, occlusion of one of the FDDs was found in the follow-up, which again shows the eminent danger of occlusion in case of an implantation of FDDs in such small-caliber vessels, which leaves the discussion about the optimal therapy method open.

Keywords

case report - flow diverter device - superior cerebellar artery - aneurysm - subarachnoid hemorrhage

Informed Consent

Informed consent was obtained from the patients included in the study.


Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments. According to the guidelines of the local ethics committee (Ethics Committee of the Medical Faculty of the HHU Düsseldorf), no ethical approval is required for this type of manuscript. Obtaining the consent of the patients is sufficient.


Supplementary Material



Publication History

Received: 07 February 2021

Accepted: 23 June 2021

Article published online:
21 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
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