Recurrence of a totally occluded aneurysm after treatment with a pipeline embolization device. (25th April 2018)

• Record Type: Journal Article
• Authors: Trivelato, Felipe Padovani; Ulhôa, Alexandre Cordeiro; Rezende, Marco Tulio; Castro-Afonso, Luis Henrique; Abud, Daniel Giansante
• Is Part Of: BMJ case reports. Volume 2018
• Publication Date: 2018-04-25
• Subjects: aneurysm -- flow diverter -- complication; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-013842
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Treatment with a pipeline embolization device (PED) is widely accepted as an excellent option for patients harboring giant, wide neck, saccular intracranial aneurysms. It has been shown to be safe and very effective. We describe a previously unreported case of a large middle cerebral artery aneurysm, related to the carotid tip, that was treated with a PED and coils. The 6 month follow-up angiogram demonstrated complete occlusion of the aneurysm. However, the 9 month angiogram revealed recurrent filling of the aneurysm sac. To our knowledge, this is the first report to describe recanalization of an aneurysm totally occluded on the control angiography after treatment with a PED. Unanswered questions include the mechanism of recanalization and the need for additional control angiograms and MRI following a previous examination revealing total aneurysm occlusion.