• Wang Ting, Seidu A Richard, Zhang Changwei, Wang Chaohua, and Xie Xiaodong.
• Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, P.R. China.
• Medicine (Baltimore). 2019 Dec 1; 98 (52): e18420e18420.

RationaleThe incidence of double aneurysms on the ophthalmic segment of the internal carotid artery (ICA) is very rare. Nevertheless, delayed rupture of a parent artery instead of the aneurysmal sac following pipeline embolization device (PLED) is unusual.Patient ConcernsWe present a 72-year-old female who was admitted at our facility with gradual onset of nonspecific visual changes.DiagnosisConventional angiography revealed 2 aneurysms located at the ophthalmic segment of the left ICA.InterventionsBoth aneurysms were successfully treated with PLED.OutcomesTwo months after discharge, the patient was rushed into the emergency with bilateral conjunctival congestion. Computed tomography revealed intracranial hemorrhage at left temporal lobe while digital subtraction angiography established a left direct carotid cavernous fistula. We utilized stent (Solitaire 6*30) assisted coils to occlude the fistula. The patient is well and go about her normal duties.LessionsManipulation of the tortuous parent artery resulted in a focal traumatic weakness in the artery and subsequently a delay tear. We are of the view that, endovascular surgeons should be on the lookout for this complication following flow deviation treatment modalities.

22 keywords...

hide…