International journal of surgery case reports · 2025
Ruptured dissection of the A1 segment of the anterior cerebral artery treated by a flow diverter to cover the A1 origin: A case report.
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Yu Jinlu
Аннотация
INTRODUCTION AND IMPORTANCE: A1 dissection of the anterior cerebral artery (ACA) is difficult to treat with endovascular treatment (EVT). There are many EVT options for treating A1 aneurysms. However, the use of a flow diverter (FD) to cover the origin of the ACA is uncommon. We such a case.
CASE PRESENTATIONS: A 51-year-old male experienced subarachnoid hemorrhage. The patient's Hunt-Hess scale score was Grade II. Angiography revealed a ruptured A1 dissecting aneurysm. Under general anesthesia, FD was used to cover the origin of the ACA. Postoperatively, the patient had no new neurological deficits. During the one-year follow-up, the patient recovered well and returned to normal life. Angiography revealed that the A1 dissecting aneurysm regressed, and the right ACA was patent and thinner than before. Follow-up magnetic resonance imaging did not reveal a brain infarction.
CLINICAL DISCUSSION: FD can be used to cover the origin of the ACA to remodeled the proximal ACA and A1 aneurysm by flow diverting effect. During follow-up, the ruptured A1 dissection can be remodeled and regressed.
CONCLUSION: Therefore, for ruptured A1 dissection, a FD to cover the origin of the ACA may be a feasible therapeutic option. After this, A1 dissecting aneurysms can regress due to reduced blood flow.
CASE PRESENTATIONS: A 51-year-old male experienced subarachnoid hemorrhage. The patient's Hunt-Hess scale score was Grade II. Angiography revealed a ruptured A1 dissecting aneurysm. Under general anesthesia, FD was used to cover the origin of the ACA. Postoperatively, the patient had no new neurological deficits. During the one-year follow-up, the patient recovered well and returned to normal life. Angiography revealed that the A1 dissecting aneurysm regressed, and the right ACA was patent and thinner than before. Follow-up magnetic resonance imaging did not reveal a brain infarction.
CLINICAL DISCUSSION: FD can be used to cover the origin of the ACA to remodeled the proximal ACA and A1 aneurysm by flow diverting effect. During follow-up, the ruptured A1 dissection can be remodeled and regressed.
CONCLUSION: Therefore, for ruptured A1 dissection, a FD to cover the origin of the ACA may be a feasible therapeutic option. After this, A1 dissecting aneurysms can regress due to reduced blood flow.