Journal of Neuroendovascular Therapy
Online ISSN : 2186-2494
Print ISSN : 1882-4072
ISSN-L : 1882-4072
18 巻, 10 号
Diversity and Inclusion in Neuroendovascular Treatments
選択された号の論文の5件中1~5を表示しています
Special Contents: Diversity and Inclusion in Neuroendovascular Treatments
Review Article
Commentary
Regular Contents
Case Report
  • Takeo Kojima, Azusa Yonezawa, Tasuku Yajima, Takahiko Nakazawa, Kaiei ...
    2024 年 18 巻 10 号 p. 267-272
    発行日: 2024年
    公開日: 2024/10/20
    [早期公開] 公開日: 2024/09/12
    ジャーナル オープンアクセス

    Objective: Dural arteriovenous fistula (dAVF) is generally treated by endovascular therapy, but transarterial embolization (TAE) carries the risk of potential complications, including distal migration of embolic material, brain infarction, and venous congestion. Intracranial hemorrhage is infrequent but remains a considerable concern.

    Case Presentation: A man in the seventh decade presented with left hemiparesis. Brain MRI revealed right corona radiata infarction and incidentally identified a left transverse sigmoid sinus dAVF. Under a diagnosis of Borden type III and Cognard type IIb, an endovascular treatment plan was initiated. After an unsuccessful attempt at transvenous embolization, TAE with Onyx (Medtronic, Minneapolis, MN, USA) successfully resolved the dAVF. However, immediate post-treatment CT revealed subarachnoid hemorrhage, leading to decompressive craniotomy. Follow-up DSA showed no residual shunts, and the cause of the bleeding remained unknown.

    Conclusion: Despite the unknown cause of bleeding, a thorough evaluation of preoperative hemodynamics and diligent postoperative examination is crucial in managing dAVF cases. Further pathological investigations are needed to gain a comprehensive understanding of such occurrences.

  • Ryoma Inui, Soichiro Abe, Hiroyuki Ishiyama, Takeyoshi Tsutsui, Akimas ...
    2024 年 18 巻 10 号 p. 273-277
    発行日: 2024年
    公開日: 2024/10/20
    [早期公開] 公開日: 2024/09/14
    ジャーナル オープンアクセス

    Objective: Stent retriever (SR) angioplasty is an adjunctive technique for acute large vessel occlusion stroke due to underlying intracranial atherosclerotic disease (ICAD-LVO). Prolonged SR deployment maintains blood flow distal to the atherosclerotic lesion until the antiplatelet agent has exerted its effect. Although SR angioplasty for ICAD-LVO has been reported, few reports are available on SR angioplasty for medium vessel occlusion stroke due to underlying ICAD (ICAD-MeVO). Here, we describe a case of SR angioplasty for acute occlusion of the left M2 segment of the middle cerebral artery (MCA) due to underlying ICAD.

    Case Presentation: A 79-year-old man with a history of left MCA M2 segment stenosis presented with motor aphasia and dysarthria. Diffusion-weighted MRI showed no high-signal intensity areas, and MRA showed occlusion of the left MCA M2 segment. The patient was diagnosed with ICAD-MeVO. After performing an MRI, the patient’s symptoms progressed to total aphasia. SR angioplasty was performed for the occlusion of the left M2 segment of the MCA. Diffusion-weighted MRI the day after the procedure showed a small area of high-signal intensity exclusively in the left putamen, while MRA confirmed recanalization of the left MCA M2 segment. Aphasia improved after the procedure. No re-occlusion was observed for 90 days, and the modified Rankin Scale score at 90 days was 2.

    Conclusion: SR angioplasty appears to be a safe option for managing MCA M2 segment occlusion.

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