J Korean Soc Radiol.  2015 Apr;72(4):300-303. 10.3348/jksr.2015.72.4.300.

Glue Embolization of the Giant Aneurysm by Reducing Thrombosis-Induced Volume Expansion Effect

• Yeom YK
• Suh DC

• KMID: 1941763
• DOI: http://doi.org/10.3348/jksr.2015.72.4.300

Abstract

A giant aneurysm due to a large intra-aneurysmal volume can be complicated by a delayed massive volume expansion caused by thrombus formation. To prevent such a severe mass effect, we obliterated the aneurysmal lumen by gluing and prevented further development of thrombosis. A 52-year-old female with a giant aneurysm at the cavernous segment of the internal carotid artery presented with tinnitus and intermittent diplopia. After confirming with a negative occlusion test, the right internal carotid artery was trapped by coiling and with further obliteration of the aneurysmal lumen by gluing. She developed a mild diplopia after the procedure and recovered without any deficit. The magnetic resonance angiography showed a stable occlusion of the aneurysm and good collateral filling of the cerebral vessel 15 months later.

MeSH Terms

Adhesives*
Aneurysm*
Carotid Artery, Internal
Diplopia
Female
Humans
Intracranial Aneurysm
Magnetic Resonance Angiography
Middle Aged
Thrombosis
Tinnitus
Adhesives

Figure

• 

  Fig. 1 A 52-year-old female presented with tinnitus and intermittent diplopia. A. The right internal carotid arteriogram showed a giant aneurysm at the end of the petrous segment protruding sphenoid sinus medially. B, C. After confirming negative occlusion test, the right internal carotid artery (ICA) was trapped by coiling (arrowheads) with further obliteration of the aneurysmal lumen by gluing to prevent volume expansion of thrombus which may lead to massive nasal or even intracranial bleeding. Note migration or spreading of the glue from the initial injection site (white part indicated by white arrow) to the final position (black part indicated by black arrow). D, E. Note decreased size of thrombosed aneurysm in the source image of magnetic resonance angiography (MRA) (E) 15 months later compared to the initial MRA (D). F. Good filling of ipsilateral cerebral vessels with obliteration of the right ICA and aneurysm.

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