Surgical neurology international · 2025
Successful endovascular occlusion of multiple fusiform aneurysms on the persistent primitive lateral basilovertebral anastomosis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Ikedo Taichi, Itazu Takaaki, Imamura Hirotoshi, Inoue Yuto, Tabata Shinya, Shimonaga Koji, Hamano Eika, Yamada Kiyofumi, Mori Hisae, Iihara Koji, Kataoka Hiroharu
Аннотация
BACKGROUND: The primitive lateral basilovertebral anastomosis (PLBA) is a transient embryonic vessel in the vertebrobasilar system that typically regresses during cerebellar artery development. Persistent PLBA (PPLBA), which forms a vertebrobasilar duplication, is a rare vascular anomaly. This is the first reported case of multiple fusiform aneurysms associated with a PPLBA.
CASE DESCRIPTION: A 14-year-old girl was diagnosed with intracranial aneurysms before undergoing coronary artery bypass grafting surgery for myocardial infarction. Digital subtraction angiography showed two fusiform aneurysms on a PPLBA, connecting the left vertebral artery (VA) and the left anterior inferior cerebellar artery (AICA). After 3 years of follow-up, a new aneurysm developed at the origin of the PPLBA, proximal to the existing two aneurysms. Due to the AICA blood flow originating mainly from the basilar artery (BA) rather than the PPLBA, endovascular parent artery occlusion of the PPLBA was planned to prevent aneurysmal rupture and subarachnoid hemorrhage. Complete occlusion of all three aneurysms was achieved without complications.
CONCLUSION: Understanding the embryological anatomy of this rare vertebrobasilar duplication involving the PPLBA, AICA, BA, and VA facilitated the successful development of a therapeutic strategy. Aneurysms associated with PPLBA exhibit various vascular structures and can be treated effectively with tailored endovascular approaches.
CASE DESCRIPTION: A 14-year-old girl was diagnosed with intracranial aneurysms before undergoing coronary artery bypass grafting surgery for myocardial infarction. Digital subtraction angiography showed two fusiform aneurysms on a PPLBA, connecting the left vertebral artery (VA) and the left anterior inferior cerebellar artery (AICA). After 3 years of follow-up, a new aneurysm developed at the origin of the PPLBA, proximal to the existing two aneurysms. Due to the AICA blood flow originating mainly from the basilar artery (BA) rather than the PPLBA, endovascular parent artery occlusion of the PPLBA was planned to prevent aneurysmal rupture and subarachnoid hemorrhage. Complete occlusion of all three aneurysms was achieved without complications.
CONCLUSION: Understanding the embryological anatomy of this rare vertebrobasilar duplication involving the PPLBA, AICA, BA, and VA facilitated the successful development of a therapeutic strategy. Aneurysms associated with PPLBA exhibit various vascular structures and can be treated effectively with tailored endovascular approaches.