2018 年 12 巻 6 号 p. 287-294
Objective: We report the case of a patient who presented with a subarachnoid hemorrhage as an initial symptom and who underwent parent artery occlusion of the internal carotid artery while maintaining the anterior circulation through the posterior circulation using a stent to treat an anterior-wall aneurysm of the internal carotid artery.
Case Presentation: The patient was a 54-year-old female who was brought to our hospital by ambulance with symptoms of headache and vomiting. A cephalic CT scan revealed a subarachnoid hemorrhage. DSA led to a diagnosis of a right internal carotid artery dissection. A balloon occlusion test (BOT) was conducted 2 days after admission, and endovascular treatment was performed 3 days after admission. An Enterprise vascular reconstruction device (VRD) was inserted into the right middle cerebral artery via the posterior communicating artery through the posterior cerebral artery, and a parent artery occlusion, which incorporated the rupture site, was performed proximal to the stent.
Conclusion: The number of patients for whom this procedure is indicated is limited, but it may facilitate safe treatment at the distal end of a parent artery occlusion while maintaining the anterior circulation.