Delayed destabilization and rupture of a giant anterior circulation aneurysm following flow-diverter placement: A case report

Flow-diverting stents have been increasingly utilized for the treatment of intracranial aneurysms, especially when there are factors that go against coil embolization, such as wide neck and large aneurysm size. However, its use does not guarantee success, especially in giant lesions, and failure to...

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Main Authors: Artur Eduardo Martio, Samuel Luís Scaravonatto Baldo Cunha, Luciano Bambini Manzato, Felipe Perini, José Ricardo Vanzin
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Brain Circulation
Subjects:
Online Access:https://journals.lww.com/10.4103/bc.bc_69_24
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author Artur Eduardo Martio
Samuel Luís Scaravonatto Baldo Cunha
Luciano Bambini Manzato
Felipe Perini
José Ricardo Vanzin
author_facet Artur Eduardo Martio
Samuel Luís Scaravonatto Baldo Cunha
Luciano Bambini Manzato
Felipe Perini
José Ricardo Vanzin
author_sort Artur Eduardo Martio
collection DOAJ
description Flow-diverting stents have been increasingly utilized for the treatment of intracranial aneurysms, especially when there are factors that go against coil embolization, such as wide neck and large aneurysm size. However, its use does not guarantee success, especially in giant lesions, and failure to obtain aneurysmal obliteration can result in long-term instability of the aneurysmal wall, leading to aneurysmal growth and late rupture. We present the case of a 65-year-old woman who suffered from a late aneurysmal dilation and rupture, 2 years and 4 months after flow-diverting treatment of a giant ophthalmic segment aneurysm. Although not fully understood, the pathophysiology of this phenomenon has one necessary factor: incomplete aneurysmal obliteration. When this scenario is present, two main factors take place: the augmentation of intrasaccular blood flow after stent delivery and the local inflammation caused by partial thrombus formation and the presence of the stent itself. To prevent this complication, complete aneurysmal obliteration must be assured, and the use of combined techniques is encouraged.
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issn 2455-4626
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publishDate 2025-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Brain Circulation
spelling doaj-art-2a3bd461ad56414aa4c7879e692ee3242025-08-20T02:26:06ZengWolters Kluwer Medknow PublicationsBrain Circulation2455-46262025-01-01111899310.4103/bc.bc_69_24Delayed destabilization and rupture of a giant anterior circulation aneurysm following flow-diverter placement: A case reportArtur Eduardo MartioSamuel Luís Scaravonatto Baldo CunhaLuciano Bambini ManzatoFelipe PeriniJosé Ricardo VanzinFlow-diverting stents have been increasingly utilized for the treatment of intracranial aneurysms, especially when there are factors that go against coil embolization, such as wide neck and large aneurysm size. However, its use does not guarantee success, especially in giant lesions, and failure to obtain aneurysmal obliteration can result in long-term instability of the aneurysmal wall, leading to aneurysmal growth and late rupture. We present the case of a 65-year-old woman who suffered from a late aneurysmal dilation and rupture, 2 years and 4 months after flow-diverting treatment of a giant ophthalmic segment aneurysm. Although not fully understood, the pathophysiology of this phenomenon has one necessary factor: incomplete aneurysmal obliteration. When this scenario is present, two main factors take place: the augmentation of intrasaccular blood flow after stent delivery and the local inflammation caused by partial thrombus formation and the presence of the stent itself. To prevent this complication, complete aneurysmal obliteration must be assured, and the use of combined techniques is encouraged.https://journals.lww.com/10.4103/bc.bc_69_24aneurysmflow-diverting stentslate rupture
spellingShingle Artur Eduardo Martio
Samuel Luís Scaravonatto Baldo Cunha
Luciano Bambini Manzato
Felipe Perini
José Ricardo Vanzin
Delayed destabilization and rupture of a giant anterior circulation aneurysm following flow-diverter placement: A case report
Brain Circulation
aneurysm
flow-diverting stents
late rupture
title Delayed destabilization and rupture of a giant anterior circulation aneurysm following flow-diverter placement: A case report
title_full Delayed destabilization and rupture of a giant anterior circulation aneurysm following flow-diverter placement: A case report
title_fullStr Delayed destabilization and rupture of a giant anterior circulation aneurysm following flow-diverter placement: A case report
title_full_unstemmed Delayed destabilization and rupture of a giant anterior circulation aneurysm following flow-diverter placement: A case report
title_short Delayed destabilization and rupture of a giant anterior circulation aneurysm following flow-diverter placement: A case report
title_sort delayed destabilization and rupture of a giant anterior circulation aneurysm following flow diverter placement a case report
topic aneurysm
flow-diverting stents
late rupture
url https://journals.lww.com/10.4103/bc.bc_69_24
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