Delayed thrombus propagation after parent artery clipping for giant fusiform aneurysms of the circle of Willis

Susumu Miyamoto, Izumi Nagata, Keisuke Yamada, Yasushi Ueno, Ichiro Nakahara, Hiroki Toda, Itaro Hattori, Haruhiko Kikuchi

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

BACKGROUND Obliteration of a giant fusiform aneurysm without significant therapeutic morbidity is extremely difficult. Ischemic complications have been often reported. METHODS Two patients with giant fusiform aneurysms of the circle of Willis are presented. Both patients underwent proximal parent artery clipping after a bypass procedure. Balloon occlusion tests confirmed both patients' ability to tolerate flow reduction after proximal clipping. RESULTS Although both patients awoke from anesthesia without neurologic deficit, they developed contralateral hemiparesis several hours after the operation as a result of a small infarct in the basal ganglia. These ischemic events might be attributed to the delayed thrombosis involving the orifice of the distal perforating arteries. CONCLUSIONS In the treatment for giant fusiform aneurysms of the circle of Willis, special attention should be paid not only to flow reduction, but also to delayed thrombus propagation that may not be predicted by preoperative balloon occlusion testing.

Original languageEnglish
Pages (from-to)89-93
Number of pages5
JournalSurgical Neurology
Volume51
Issue number1
DOIs
Publication statusPublished - 01-1999
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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