Objective: We report a rare case of posterior condylar canal (PCC) dural arteriovenous fistula (dAVF) treated by transvenous embolization (TVE).

Case Presentations: A male in his 60s with pulsatile tinnitus visited our hospital. DSA revealed dAVF near thePCC. Feeders were bilateral ascending pharyngeal arteries and left occipital artery, and drainer was posterior condylar vein (PCV). We treated this case by TVE of the shunted pouch and PCV using coils and n-butylcyanoacrylate without complication.

Conclusion: Understanding of angioarchitecture using reconstruction of 3D-DSA was useful for the diagnosis and treatment of the rare PCC dAVF case.

Objective: Spontaneous occlusion of unruptured aneurysm is extremely rare. Previous reports have described spontaneous occlusion of ruptured aneurysms, giant-size aneurysms, and dissecting aneurysms. To our knowledge, there have been no reports on the spontaneous occlusion of unruptured aneurysms following an attempted endovascular procedure.

Case Presentation: A 70-year-old female patient whose unruptured aneurysm was detected by brain checkup was referred to our department. Coiling was attempted but failed due to instability of the microcatheter. Immediately after the procedure, a head MRA showed that the aneurysm remained, but follow-up MRA and 3D-CTA 6 months after the endovascular procedure demonstrated spontaneous occlusion of the aneurysm.

Conclusion: We report a spontaneous occlusion of unruptured, small cerebral aneurysm following an attempted coil embolization.

Objective: Ruptured lateral spinal artery (LSA) or vasa corona aneurysms are very rare. We report a case of duplicated posterior inferior cerebellar artery (PICA) and ruptured aneurysm in the vasa corona treated with n-butyl-2-cyanoacrylate (NBCA) embolization.

Case Presentation: A 44-year-old woman experienced sudden headache and impaired consciousness. A CT scan revealed massive subarachnoid hemorrhage in the posterior fossa. A cerebral CT angiography showed a vascular anomaly around the PICA. We performed selective digital subtraction angiography, which revealed duplicate PICA and anastomosis between the anterior spinal artery (ASA) and PICA via the LSA and vasa corona. We found that the aneurysms were located in the vasa corona and performed NBCA embolization of the aneurysms via the ASA.

Conclusion: We were able to understand the complicated vascular anatomy around the duplicated PICA and pial network by detailed examination and NBCA embolization of the vasa corona aneurysms clearly.

Objective: We report the usefulness of contralateral angiography in the treatment of a dural arteriovenous fistula (DAVF) of the anterior condylar confluence (ACC) with ocular manifestations.

Case Presentation: A 53-year-old woman had developed pulsatile tinnitus six months previously. Three months later, she also developed ocular pain, conjunctival hyperemia, and eyelid swelling. Magnetic resonance angiography revealed abnormal, hyperintense, thin vessels around the right hypoglossal canal. Arterial spin labeling showed abnormal, hyperintense signals from the right inferior petrosal vein to the superior ophthalmic vein. She was diagnosed with ACC DAVF by digital subtraction angiography. Because both the shunt point and the drainage vein anatomy could be clearly visualized on contralateral angiography, transvenous coil embolization was performed completely. The DAVF was treated, and her symptoms improved immediately.

Conclusion: Contralateral angiography is a useful method in this case because it provides a clear vascular anatomy.

Objective: We report a case of successful thrombus aspiration using a balloon guide catheter for brachial artery occlusion.

Case Presentation: The patient was a 71-year-old man with a history of cardiogenic cerebral embolism who was taking apixaban. He was examined for numbness of the left upper limb and was found to have a National Institutes of Health Stroke Scale (NIHSS) score of 3. Intravenous recombinant tissue plasminogen activator (rt-PA) therapy and mechanical thrombectomy were considered. Although an embolic cerebral infarction was found in the right occipital lobe, the imaging findings did not explain his symptoms. The left brachial artery was not palpable, which indicated an embolus in an upper extremity vessel. Proximal occlusion of the left brachial artery was diagnosed through angiography. Thrombus aspiration with a balloon-guided catheter was used to achieve recanalization.

Conclusion: To our knowledge, this is the first report to describe the successful treatment of brachial artery occlusion using suction with a balloon-guided catheter. It may be possible to quickly perform catheterization in cases of stroke mimics if the patients are brought to facilities equipped for mechanical thrombectomy.

Objective: Common carotid artery aneurysm (CCA-AN) is a rare disease. Therefore, an effective treatment has not yet been established. Herein, we report a case of mycotic CCA-AN that was unexpectedly treated by coil embolization with stenting.

Case Presentation: An 85-year-old female who had renal dysfunction presented with painful swelling of the left neck and was diagnosed with mycotic CCA-AN. She underwent carotid artery stenting using overlapped closed-cell stents, which had the anticipated flow-diverting effect. We reduced the amount of contrast medium by using ultrasonography to avoid exacerbation of renal function. However, a partially-uncovered orifice of the aneurysm was identified 5 days after the procedure because of shortening of the stents. Additional coil embolization was performed after the stenting and the aneurysm was completely thrombosed.

Conclusion: We report the case in which a good outcome was obtained by coil embolization as the retreatment for mycotic CCA-AN.