2019 Volume 69 Issue 2 Pages 135-138
We report a case of an unruptured cerebral aneurysm associated with internal carotid artery (ICA) hypoplasia and an aberrant right subclavian artery successfully treated with coil embolization. A 56-year-old female was referred to our hospital for a left unruptured ICA aneurysm with a bleb. She had no signs of neurological deficit. Computed tomography angiography and digital subtraction angiography revealed the presence of a right ICA hypoplasia and an aberrant right subclavian artery. The size of the aneurysm was 7.5×5.8 mm, and its neck was 3.6 mm. We treated the aneurysm with balloon-assisted coil embolization. Temporary endovascular balloon occlusion of the ICA was needed several times to finish the embolization. The aneurysm was completely obliterated, with no signs of neurological deficit after surgery. In the case of an ICA hypoplasia, the incidence of a cerebral aneurysm is suggested to be higher than in the general population due to the increase in the hemodynamic stress on the normally developed side. The coexistence of ICA hypoplasia and an aberrant right subclavian artery is rare. Accessibility limitations and ischemic tolerance must be considered when treating patients with congenital vascular anomalies via endovascular surgery.
