Rupture of giant vertebrobasilar aneurysm following flow diversion

Mechanical stretch as a potential mechanism for early aneurysm rupture

Benjamin Fox, William Edward Humphries, Vinodh T. Doss, Daniel Hoit, Lucas Elijovich, Adam Arthur

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

A patient with a giant symptomatic vertebrobasilar aneurysm was treated by endoscopic third ventriculostomy for obstructive hydrocephalus followed by treatment of the aneurysm by flow diversion using a Pipeline Embolization Device. After an uneventful procedure and initial periprocedural period, the patient experienced an unexpected fatal subarachnoid hemorrhage 1 week later. Autopsy demonstrated extensive subarachnoid hemorrhage and aneurysm rupture (linear whole wall rupture). The patent Pipeline Embolization Device was in its intended location, as was the persistent coil occlusion of the distal left vertebral artery. The aneurysm appeared to rupture in a linear manner and contained a thick large expansile clot that seemed to disrupt or rupture the thin aneurysm wall directly opposite the basilar artery/Pipeline Embolization Device. We feel the pattern of aneurysm rupture in our patient supports the idea that the combination of flow diversion and the resulting growing intra-aneurysmal thrombus can create a mechanical force with the potential to cause aneurysm rupture.

Original languageEnglish (US)
Pages (from-to)e37
JournalJournal of neurointerventional surgery
Volume7
Issue number11
DOIs
StatePublished - Nov 1 2015

Fingerprint

Aneurysm
Rupture
Subarachnoid Hemorrhage
Equipment and Supplies
Ventriculostomy
Basilar Artery
Vertebral Artery
Hydrocephalus
Autopsy
Thrombosis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Rupture of giant vertebrobasilar aneurysm following flow diversion : Mechanical stretch as a potential mechanism for early aneurysm rupture. / Fox, Benjamin; Humphries, William Edward; Doss, Vinodh T.; Hoit, Daniel; Elijovich, Lucas; Arthur, Adam.

In: Journal of neurointerventional surgery, Vol. 7, No. 11, 01.11.2015, p. e37.

Research output: Contribution to journalArticle

@article{d2cd248b0f6a4a85871ae4f58c4608d8,
title = "Rupture of giant vertebrobasilar aneurysm following flow diversion: Mechanical stretch as a potential mechanism for early aneurysm rupture",
abstract = "A patient with a giant symptomatic vertebrobasilar aneurysm was treated by endoscopic third ventriculostomy for obstructive hydrocephalus followed by treatment of the aneurysm by flow diversion using a Pipeline Embolization Device. After an uneventful procedure and initial periprocedural period, the patient experienced an unexpected fatal subarachnoid hemorrhage 1 week later. Autopsy demonstrated extensive subarachnoid hemorrhage and aneurysm rupture (linear whole wall rupture). The patent Pipeline Embolization Device was in its intended location, as was the persistent coil occlusion of the distal left vertebral artery. The aneurysm appeared to rupture in a linear manner and contained a thick large expansile clot that seemed to disrupt or rupture the thin aneurysm wall directly opposite the basilar artery/Pipeline Embolization Device. We feel the pattern of aneurysm rupture in our patient supports the idea that the combination of flow diversion and the resulting growing intra-aneurysmal thrombus can create a mechanical force with the potential to cause aneurysm rupture.",
author = "Benjamin Fox and Humphries, {William Edward} and Doss, {Vinodh T.} and Daniel Hoit and Lucas Elijovich and Adam Arthur",
year = "2015",
month = "11",
day = "1",
doi = "10.1136/neurintsurg-2014-011325.rep",
language = "English (US)",
volume = "7",
pages = "e37",
journal = "Journal of NeuroInterventional Surgery",
issn = "1759-8478",
publisher = "BMJ Publishing Group",
number = "11",

}

TY - JOUR

T1 - Rupture of giant vertebrobasilar aneurysm following flow diversion

T2 - Mechanical stretch as a potential mechanism for early aneurysm rupture

AU - Fox, Benjamin

AU - Humphries, William Edward

AU - Doss, Vinodh T.

AU - Hoit, Daniel

AU - Elijovich, Lucas

AU - Arthur, Adam

PY - 2015/11/1

Y1 - 2015/11/1

N2 - A patient with a giant symptomatic vertebrobasilar aneurysm was treated by endoscopic third ventriculostomy for obstructive hydrocephalus followed by treatment of the aneurysm by flow diversion using a Pipeline Embolization Device. After an uneventful procedure and initial periprocedural period, the patient experienced an unexpected fatal subarachnoid hemorrhage 1 week later. Autopsy demonstrated extensive subarachnoid hemorrhage and aneurysm rupture (linear whole wall rupture). The patent Pipeline Embolization Device was in its intended location, as was the persistent coil occlusion of the distal left vertebral artery. The aneurysm appeared to rupture in a linear manner and contained a thick large expansile clot that seemed to disrupt or rupture the thin aneurysm wall directly opposite the basilar artery/Pipeline Embolization Device. We feel the pattern of aneurysm rupture in our patient supports the idea that the combination of flow diversion and the resulting growing intra-aneurysmal thrombus can create a mechanical force with the potential to cause aneurysm rupture.

AB - A patient with a giant symptomatic vertebrobasilar aneurysm was treated by endoscopic third ventriculostomy for obstructive hydrocephalus followed by treatment of the aneurysm by flow diversion using a Pipeline Embolization Device. After an uneventful procedure and initial periprocedural period, the patient experienced an unexpected fatal subarachnoid hemorrhage 1 week later. Autopsy demonstrated extensive subarachnoid hemorrhage and aneurysm rupture (linear whole wall rupture). The patent Pipeline Embolization Device was in its intended location, as was the persistent coil occlusion of the distal left vertebral artery. The aneurysm appeared to rupture in a linear manner and contained a thick large expansile clot that seemed to disrupt or rupture the thin aneurysm wall directly opposite the basilar artery/Pipeline Embolization Device. We feel the pattern of aneurysm rupture in our patient supports the idea that the combination of flow diversion and the resulting growing intra-aneurysmal thrombus can create a mechanical force with the potential to cause aneurysm rupture.

UR - http://www.scopus.com/inward/record.url?scp=84945188825&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84945188825&partnerID=8YFLogxK

U2 - 10.1136/neurintsurg-2014-011325.rep

DO - 10.1136/neurintsurg-2014-011325.rep

M3 - Article

VL - 7

SP - e37

JO - Journal of NeuroInterventional Surgery

JF - Journal of NeuroInterventional Surgery

SN - 1759-8478

IS - 11

ER -