2018 年 12 巻 8 号 p. 393-397
Objective: We report a patient with allergy to iodinated contrast medium for whom a working angle was prepared based on preoperative CTA data, and coil embolization was performed using gadolinium (Gd) contrast medium at minimum.
Case Presentation: The patient was a 44-year-old female. For detailed examination of an unruptured cerebral aneurysm, contrast-enhanced CT was performed, leading to a diagnosis of an unruptured cerebral aneurysm, measuring 7 mm in maximum diameter, beside the left internal carotid artery. At this point, serious allergic symptoms were observed. Based on the CT data, we prepared a fluoroscopic image of the skull at a working angle on endovascular treatment. Under general anesthesia, body movement was restricted, and angiography with Gd contrast medium was performed by identifying the same angle of fluoroscopy as that on the above fluoroscopic image. Subsequently, coil embolization of the aneurysm was conducted using this image as a road map. Treatment was completed without complications. The volume of Gd contrast medium infused into the artery was 10 mL.
Conclusion: The treatment of an unruptured cerebral aneurysm with a small volume of Gd contrast medium could be performed by adapting image processing from the preoperative CT data to fluoroscopy at the time of treatment.