Kissing aneurysmsに対する血管内治療施行例の検討

抄録

Kissing aneurysms are defined as two adjacent aneurysms that have their own neck and partially adhere to each other. In our institution, we summarized these patients and four cases of ruptured kissing aneurysms were treated by endovascular treatment. Of the four, one originated from internal carotid-posterior communicating and ipsilateral internal carotid-anterior choroidal arteries and the remaining originated from distal anterior cerebral aneurysms. Three of the four cases were able to perform coil embolization from the same working angle of each other. All these cases were successfully treated by endovascular treatment without complications.

In the surgical treatment of kissing aneurysms, few reports suggested the usefulness of endovascular treatment. However, surgical clipping of kissing aneurysms warrants great caution due to lack of sufficient spaces around the aneurysmal neck than solitary aneurysm, and it is difficult to determine which aneurysm has bled and should be clipped first. The potential for premature rupture may be higher than ordinary aneurysm. On the other hand, endovascular treatment can be safely performed when the working angle of the aneurysmal neck is confirmed.