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Journal of Korean Neurosurgical Society 2009;45(4): 260-263.
doi: https://doi.org/10.3340/jkns.2009.45.4.260
Ideal Internal Carotid Artery Trapping Technique without Bypass in a Patient with Insufficient Collateral Flow.
Joon Ho Chung, Yong Sam Shin, Yong Cheol Lim, Minjung Park
1Department of Neurosurgery, Kangnam St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea. nsshin@catholic.ac.kr
2Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea.
3Ajou University School of Medicine, Suwon, Korea.
ABSTRACT
Internal carotid artery (ICA) trapping can be used for treating intracranial giant aneurysm, blood blister-like aneurysms and ICA rupture during the surgery. We present a novel ICA trapping technique which can be used with insufficient collaterals flow via anterior communicating artery (AcoA) and posterior communicating artery (PcoA). A patient was admitted with severe headache and the cerebral angiography demonstrated a typical blood blister-like aneurysm at the contralateral side of PcoA. For trapping the aneurysm, the first clip was placed at the ICA just proximal to the aneurysm whereas the distal clip was placed obliquely proximal to the origin of the PcoA to preserve blood flow from the PcoA to the distal ICA. The patient was completely recovered with good collaterals filling to the right ICA territories via AcoA and PcoA. This technique may be an effective treatment option for trapping the aneurysm, especially when the PcoA preservation is mandatory.
Key Words: Blood-blister like aneurysm; Internal carotid artery; Trapping; Subarachnoid hemorrhage
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