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Surg Neurol Int

Title:		Giant vertebral aneurysm: A case report detailing successful treatment with combined stenting and surgery
Author(s):		Capo G; Vescovi MC; Toniato G; Petralia B; Gavrilovic V; Skrap M;
Address:		"Department of Neurosurgery, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy. Department of Neuroradiology, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy"
Journal Title:		Surg Neurol Int
Year:		2018
Volume:		20180116
Issue:
Page Number:		6 -
DOI:		10.4103/sni.sni_170_17
ISSN/ISBN:		2229-5097 (Print) 2152-7806 (Electronic) 2152-7806 (Linking)
Abstract:		"BACKGROUND: Giant aneurysms (>25 mm) arising from the vertebral artery (VA) often present with slow progression of symptoms and signs because of gradual brainstem and cranial nerve compression. The underlying pathophysiology is not well understood, and treatment, wherever possible, is tailored to each singular case. Endovascular management does not usually solve the problem of mass compression, whereas surgical treatment involves several complications. CASE DESCRIPTION: A 58-year-old woman presented with a continuously growing giant right VA aneurysm, partially thrombosed, even after endovascular treatment (placement of two diversion flow stents). Operative partial aneurysmectomy and intraoperative placement of an endovascular balloon allowed removal from circulation without significant bleeding with a good neurological outcome. CONCLUSIONS: The variability of VA thrombosed giant aneurysms implies a customized therapeutic strategy. Combined endovascular techniques and surgical clipping allow safe and successful trapping and aneurysmectomy. This case highlights the benefits of treating similar pathologies with a combination of both techniques"
Keywords:		Endovascular treatment fenestrated clip flow-diverter giant aneurysm neurovascular surgery temporary balloon occlusion vertebral artery;
Notes:		"PubMed-not-MEDLINECapo, Gabriele Vescovi, Maria C Toniato, Giovanni Petralia, Benedetto Gavrilovic, Vladimir Skrap, Miran eng Case Reports 2018/02/09 Surg Neurol Int. 2018 Jan 16; 9:6. doi: 10.4103/sni.sni_170_17. eCollection 2018"