• World Neurosurg · Dec 2019

    Review Case Reports

    Flow-Diverter Stent for an Unruptured Aneurysm at the Junction of the Internal Carotid Artery and Persistent Primitive Trigeminal Artery: A Case Report and Literature Review.

    • Hirotaka Sato, Koichi Haraguchi, Yashuhiro Takahashi, Shunya Ohtaki, Tadakazu Shimizu, Nobuyuki Matsuura, Kazumi Ogane, and Takeo Ito.
    • Department of Neurosurgery, Hakodate Shintoshi Hospital, Hakodate, Japan. Electronic address: kyokui080021@gmail.com.
    • World Neurosurg. 2019 Dec 1; 132: 329-332.

    BackgroundPersistent primitive trigeminal artery (PPTA), which is a fetal carotid-basilar anastomosis, is the most common embryologic vascular remnant persisting in adults. Aneurysms can arise between the internal carotid artery (ICA) and PPTA. Here we present a case of ICA-PPTA aneurysm treated with a flow-diverter stent.Case DescriptionA 52-year-old woman had left abducens nerve palsy. Imaging detected a large left ICA-PPTA aneurysm, which we chose to treat with a flow-diverter stent after embolizing the PPTA with a coil. Although the abducens nerve palsy did not change, there were no signs of cerebral infarction, and no new symptoms appeared postoperatively. Blood flow in the aneurysm had disappeared on digital subtraction angiography after 6 months.ConclusionsThis is the first case report of ICA-PPTA aneurysm successfully treated with a flow-diverter stent. We could stop blood flow from the posterior circulation by embolizing the PPTA with a coil, allowing the use of a flow-diverter stent. This report can be used as a reference for the procedure in future work.Copyright © 2019 Elsevier Inc. All rights reserved.

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