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Treatment of a posterior cerebral artery aneurysm in the context of complex cardio-cerebrovascular variations using the Tubridge flow diverter

Journal of Cerebrovascular and Endovascular Neurosurgery / Journal of Cerebrovascular and Endovascular Neurosurgery, (P)2234-8565; (E)2287-3139
2024, v.26 no.1, pp.65-70
https://doi.org/10.7461/jcen.2023.E2023.04.009
Dmytriw Adam A. (Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael’s Hospital, University of Toronto, Toronto, Canada)
Grewal Sahibjot (Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael’s Hospital, University of Toronto, Toronto, Canada)
Cancelliere Nicole M. (Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael’s Hospital, University of Toronto, Toronto, Canada)
Patel Aman B. (Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women’s Hospital, Harvard Medical School, Boston, USA)
Pereira Vitor Mendes (Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael’s Hospital, University of Toronto, Toronto, Canada)
Ren Xiaolu (Department of Neurosurgery and Laboratory of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, People’s Republic of China)
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Abstract

We present a case of intracranial aneurysm located in the P1 segment of left posterior cerebral artery in the context of tetralogy of Fallot. Complex variations included right aortic arch with abnormal branching. Also, the bilateral vertebral arteries were absent, with a type I persistent proatlantal intersegmental artery of the left side. The aneurysm was treated with endovascular intervention with a Tubridge flow diverter and was noted to be completely cured on 6-month follow-up. We discuss the many considerations in this patient including developmental and modern-era treatment.

keywords
Interventional neuroradiology, Endovascular aneurysm repair, Flow diversion, Tetralogy of Fallot, Proatlantal artery

Journal of Cerebrovascular and Endovascular Neurosurgery