胼周动脉A3段侧—侧搭桥治疗介入治疗后复发的大脑前动脉A1段动脉瘤一例

A3-A3 side-to-side anastomosis combined with endovascular intervention in recurrent complex anterior artery aneurysm:a case report and literature review

一例28岁女性患者因“突发头痛伴呕吐1天”入院。颅脑cT平扫提示蛛网膜下腔出血。数字减影血管造影检查提示左侧大脑前动脉A1段远侧大型动脉瘤。急诊全身麻醉下行支架辅助动脉瘤栓塞术，术毕即刻动脉瘤完全栓塞，载瘤动脉通畅。术后3个月随访发现动脉瘤明显复发。随后通过双侧胼周动脉A3-A3搭桥后再次行动脉瘤及载瘤动脉栓塞治疗，取得满意疗效。

A 28-year-old female patient was admitted to the Second Affiliated Hospital, Zhejiang University School of Medicine, with sudden headache and vomiting for 1 day. CT scan conducted at emergency revealed subarachnoid hemorrhage, whereas digital subtraction angiography demonstrated a wide-neck aneurysm located at A1 segment of the left anterior cerebral artery. The aneurysm was totally coiled using stent assistance, which, however, was recanalized at 3 month follow-up. This patient was then subjected to aneurysm and parent artery segments, who recovered well and discharged occlusion after bypass of the bilateral A3 without ischemic complications.