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Neurointervention. 2017 Mar;12(1):40-44. doi: 10.5469/neuroint.2017.12.1.40. Epub 2017 Mar 6.

A Case of Ruptured Blood Blister-like Aneurysm Treated with Pipeline Embolization Device: Clinical Significance of Fetal-type Posterior Communicating Artery.

Author information

1
Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, Korea.
2
Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.; Department of Radiology, Kyungpook National University School of Medicine, Daegu, Korea.
3
Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
4
Department of Radiology, Kyungpook National University School of Medicine, Daegu, Korea.
5
Department of Radiology, Younsei University College of Medicine, Seoul, South, Korea.

Abstract

Blood-blister like aneurysms (BBAs) are challenging lesions because of their wide fragile neck. Flow-diverting stents (FDSs), such as the Pipeline Embolization Device (PED), have been applied to treat BBAs less amenable to more established techniques of treatment. However, the use of FDSs, including the PED, in acute subarachnoid hemorrhage (SAH) still remains controversial. We report a case of aneurysm regrowth following PED application for a ruptured BBA that overlapped the origin of the dominant posterior communicating artery (PCoA), which was successfully treated after coil trapping of the origin of the fetal-type PCoA. And, we discuss the clinical significance of the fetal-type PCoA communicating with a BBA in terms of PED failure.

KEYWORDS:

Blood blister-like aneurysm; Coil embolization; Fetal circulation; Flow diversion; Pipeline Embolization Device

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