Posteroinferior Cerebellar Artery (PICA) Fusiform Aneurysm Ruptured Related with a Pure Arterial Malformation: Case Report and Technical Note (NBCA Embolization under Roadmap-Fluoroscopy)  

作　　者：Maria Del Rosario Sosa-Martinez Guy G. Broc-Haro Javier Valdes-Garcia Christopher Mader-Alba Daniel Juarez-Rebollar Maria Del Rosario Sosa-Martinez;Guy G. Broc-Haro;Javier Valdes-Garcia;Christopher Mader-Alba;Daniel Juarez-Rebollar(Neurosurgery and Neurological Endovascular Therapy Department, “Lic. Adolfo López Mateos” Regional Hospital of the Security and Social Institute of the State Workers, Mexico City, Mexico)

机构地区：[1]Neurosurgery and Neurological Endovascular Therapy Department, “Lic. Adolfo López Mateos” Regional Hospital of the Security and Social Institute of the State Workers, Mexico City, Mexico

出　　处：《Open Journal of Modern Neurosurgery》2021年第3期137-143,共7页现代神经外科学进展（英文）

摘　　要：<strong>Background:</strong> The pure arterial malformation (PAM) lesion has been recently described as a vascular pathology characterized by the sole presence of coiled, sometimes ectatic, arterial loops. 2% of the fusiform aneurysms are located in the vertebral-posterior inferior cerebellar arteries. <strong>Case Presentation:</strong> A 60 years old female with subarachnoid hemorrhage was diagnosed with a fusiform aneurysm in the right PICA related with a PAM in the digital subtraction angiography (DSA). With a negative super-selective Wada test, the patient was treated with embolization of the two lesions and the PICA for being in the same arterial territory with adhesive embolic liquid under roadmap fluoroscopy technique. The patient had a satisfactory clinical evolution and no added neurological deficit, so she was discharged 3 days after the treatment. <strong>Conclusion:</strong> These two vascular lesions located in the same artery are very rare and more in the PICA territory. It is important to make the best decision to treat them because of the potential complications;that’s why the procedure was supported with super-selective Wada test and neuromonitoring of the PICA territory. The injection of the mixture of NBCA and Lipiodol<span style="white-space:nowrap;">^&#174;</span> under roadmap fluoroscopy is very safe.<strong>Background:</strong> The pure arterial malformation (PAM) lesion has been recently described as a vascular pathology characterized by the sole presence of coiled, sometimes ectatic, arterial loops. 2% of the fusiform aneurysms are located in the vertebral-posterior inferior cerebellar arteries. <strong>Case Presentation:</strong> A 60 years old female with subarachnoid hemorrhage was diagnosed with a fusiform aneurysm in the right PICA related with a PAM in the digital subtraction angiography (DSA). With a negative super-selective Wada test, the patient was treated with embolization of the two lesions and the PICA for being in the same arterial territory with adhesive embolic liquid under roadmap fluoroscopy technique. The patient had a satisfactory clinical evolution and no added neurological deficit, so she was discharged 3 days after the treatment. <strong>Conclusion:</strong> These two vascular lesions located in the same artery are very rare and more in the PICA territory. It is important to make the best decision to treat them because of the potential complications;that’s why the procedure was supported with super-selective Wada test and neuromonitoring of the PICA territory. The injection of the mixture of NBCA and Lipiodol<span style="white-space:nowrap;">^&#174;</span> under roadmap fluoroscopy is very safe.

关 键 词：Fusiform Aneurysm Pure Arterial Malformation N-Butyl Cyanoacrylate Roadmap Fluoroscopy 

分 类 号：R73[医药卫生—肿瘤]