Ruptured dissection of the A1 segment of the anterior cerebral artery treated by a flow diverter to cover the A1 origin: A case report.

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.