Vertebral Arter İnternal Karotid Arter Anastomozu Yoluyla Bir Büyük Supraklinoid Karotid Anevrizmasının Tekrar Kanalizasyonu: Bir Olgu Sunumu

Abstract

Proximal ligation of the internal carotid artery (ICA) with high-flow bypass is one of the surgical strategies for treating large, unclippableICA aneurysms. We encountered a rare case of recanalization of a large ICA aneurysm that disappeared after high-flow bypass surgery, andsubsequently reappeared via an elicited vertebral artery (VA)-ICA anastomosis (anastomosis between the anterior meningeal artery branchingfrom the right VA, and the ascending pharyngeal artery branching (APA) from the right ICA). To the best of our knowledge, this is the first casereport describing angiographical recurrence of a large ICA aneurysm after the surgery. Periodic long-term follow-up by neuroimaging may benecessary after this surgery, particularly in cases of ICA proximal ligation with the ICA aneurysm, when the APA has not been clearly identifiedas a branch from the ipsilateral external carotid artery on the preoperative angiogram.