A case of flow diverter treatment by transradial approach of a left internal carotid artery aneurysm with an aberrant right subclavian artery

Abstract

A 30-year-old woman was referred to our hospital for close examination and treatment of her left internal carotid artery aneurysm, which was discovered incidentally by her primary care physician. Left internal carotid artery aneurysms of wide neck were found on close examination, and the treatment policy was to provide flow diversion treatment. Aberrant right subclavian artery (ARSA) was found in the preoperative examination. Since long-term antiplatelet therapy was required, a transradial approach (TRA) was adopted. Treatment was performed in a triaxial system, and a Pipeline FLEX with Shield technology was successfully placed in the internal carotid artery to cover the aneurysm as planned. Postoperatively, MRI showed micro cerebral infarction, but it was asymptomatic. The patient was discharged home at mRS 0 with no complications at the puncture site. TRA may be an effective approach to flow diversion treatment and should be considered in patients with ARSA.