Abstract
A 21-year-old female patient presented with spontaneous subarachnoid hemorrhage (SAH) and a large right frontal lobe intracerebral hematoma (ICH), graded Hunt and Hess IV and Fisher IV. The hemorrhage was caused by the rupture of an aneurysm of the anterior communicating artery (AcomA). The aneurysm was treated in the acute phase with the implantation of a single-layer spherical 7 mm WEB device, resulting in complete aneurysm occlusion with no complications. Follow-up DSA 6 months after implantation of the WEB device showed continued aneurysm perfusion. A second follow-up DSA was performed 11 months after SAH under general anesthesia. Re-treatment with stent-assisted recoiling was carried out without complications. Residual aneurysms after WEB device confer similar treatment possibilities as untreated aneurysm, including advanced endovascular treatment methods such as stent- and balloon-assisted coiling as well as the implantation of a flow diverter. The management of residual and recurrent aneurysms previously treated with a WEB device is the main topic of this chapter.
This is a preview of subscription content, log in via an institution.
References
Clajus C, Strasilla C, Fiebig T, Sychra V, Fiorella D, Klisch J. Initial and mid-term results from 108 consecutive patients with cerebral aneurysms treated with the WEB device. J Neurointerv Surg. 2017;9(4):411–7. https://doi.org/10.1136/neurintsurg-2016-012276.
Durner G, Özpeynirci Y, Schmitz B, Wirtz CR, König R, Pala A. Clipping as re-treatment strategy after treatment of a cerebral aneurysm with the Woven EndoBridge embolization device: case report. J Neurosurg. 2018;130:1–4. https://doi.org/10.3171/2017.10.JNS171528.
Gross BA, Ares WJ, Ducruet AF, Jadhav AP, Jovin TG, Jankowitz BT. A clinical comparison of Atlas and LVIS Jr stent-assisted aneurysm coiling. J Neurointerv Surg. 2019;11(2):171–4. https://doi.org/10.1136/neurintsurg-2018-014208.
Gupta M, Cheung VJ, Abraham P, Wali AR, Santiago-Dieppa DR, Gabel BC, Almansouri A, Pannell JS, Khalessi AA. Low-profile Visualized Intraluminal Support Junior device for the treatment of intracranial aneurysms. Cureus. 2017;9(2):e1037. https://doi.org/10.7759/cureus.1037.
Kabbasch C, Goertz L, Siebert E, Herzberg M, Hamisch C, Mpotsaris A, Dorn F, Liebig T. Treatment strategies for recurrent and residual aneurysms after Woven Endobridge implantation. J Neurointerv Surg. 2018;11:390. https://doi.org/10.1136/neurintsurg-2018-014230.
Mihalea C, Escalard S, Caroff J, Ikka L, Rouchaud A, Da Ros V, Pagiola I, Marenco de la Torre JJ, Yasuda T, Popa BV, Ples H, Benachour N, Ozanne A, Moret J, Spelle L. Balloon remodeling-assisted Woven EndoBridge technique: description and feasibility for complex bifurcation aneurysms. J Neurointerv Surg. 2018; https://doi.org/10.1136/neurintsurg-2018-014104.
Santillan A, Boddu S, Schwarz J, Lin N, Gobin YP, Knopman J, Patsalides A. LVIS Jr. stent for treatment of intracranial aneurysms with parent vessel diameter of 2.5 mm or less. Interv Neuroradiol. 2018;24(3):246–53. https://doi.org/10.1177/1591019918759307.
van Rooij S, van Rooij WJ, Sluzewski M, Peluso JP. The Woven EndoBridge (WEB) for recurrent aneurysms: clinical and imaging results. Interv Neuroradiol. 2019;25(1):21–6. https://doi.org/10.1177/1591019918798806.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this entry
Cite this entry
Clajus, C., Klisch, J., Lobsien, D. (2019). Anterior Communicating Artery Aneurysm: SAH and Large Intracerebral Hematoma Due to a Ruptured Anterior Communicating Artery Aneurysm, Initially Treated with a WEB Device, and Re-treatment of a Residual Aneurysm with Stent-Assisted Coiling. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Aneurysm Casebook. Springer, Cham. https://doi.org/10.1007/978-3-319-70267-4_125-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-70267-4_125-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-70267-4
Online ISBN: 978-3-319-70267-4
eBook Packages: Springer Reference MedicineReference Module Medicine