English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

Dear editor, A 49-year-old woman was presented with sudden headache, nausea, and vomiting. Head computed tomography (Figure 1(a)) and initial angiography taken in local hospital revealed subarachnoidhemorrhagewithout presentation of aneurysm. Review of 3D angiography (Figure 1(b)) 50 days later found a tiny aneurysm of basilar perforating artery. Angiography taken in our hospital (Figure 1(c)) confirmed the existence of the perforator aneurysm. The patient was prepared with Aspirin (300mg) and Plavix (300mg) for three days. During the operation, Marathon microcatheter (ev3, USA) failed to enter the cavity of aneurysm after several attempts. We put the Traxcess 14 guidewire (Microvention, USA) into the aneurysmand advanced themicrocatheter close to the pedicle, then treated the guidewire as if a stent lead wire (Figure 1(f)), connected it to the Solitaire stent detachment system (ev3, USA) at 4.0V and 1.0mA electronic current (Figure 1(d,e)), detached it for 4min. The aneurysm completely disappeared (Figure 1(g)). The patient suffered no consequences from this procedure. The patient was followed up with angiography (Figure 1(h)) two years later and with telephone till now. No revascularization of aneurysm was found. Reports of perforator blister-like aneurysm treatment were seldom, especially cases treated with endovascular therapy. Re-rupture occurred in one of seven cases in our review that was not treated early. Hamel et al. reported failure of advancement of microcatheter into aneurysm, followed by surgical clipping, which was then complicated by tension pneumocephalus. Peschillo et al. performed three cases using Fow-diverting stents. Complications occurred in all three patients and one case resulted in permanent morbidity. Pure electrocoagulation provides a new thought when microcatheter could not be navigated into the aneurysm. Twenty-four months follow-up and systemic heparinization can exclude the effect of vessel spasm and thrombus formation to some extent. However, the main concern about this endovascular technique is its durability.

international journal of stroke

Endovascular pure electrocoagulation of intracranial perforator blister-like aneurysm not accessible to microcatheter—New approach to treat small vessel hemorrhage disease