Guglielmi detachable coilを用いて治療した破裂fenestrated aneurysm of vertebral artery unionの1例

Ruptured Fenestrated Aneurysm of Vertebral Artery Union Successfully Treated by Endovascular Surgery with GDC

Ⅰ．はじめに

　椎骨脳底動脈系，中でも脳底動脈本幹部動脈瘤に対する開頭・クリッピング術は，一般に非常に難易度が高く，特に急性期例の直達手術は困難である^6,14）．一方，近年発展してきたGuglielmi de-tachable coil（GDC）を用いた血管内治療は，動脈瘤の解剖学的位置や患者の全身状態不良などの理由で開頭術が困難な例に対しても低侵襲で治療が行えるという利点をもつ^17）．今回われわれは，くも膜下出血で発症したfenestrated aneurysm of VA unionに対し，急性期に脳血管内手術を行い良好な結果が得られたので，若干の文献的考察を加えて報告する．

It is difficult to operate on ruptured basilar artery aneurysms in the acute phase because of the anatomical com-plexity, brain swelling, patients' medical condition, etc., but because there is some risk of rebleeding and/or vaso-spasm if surgery is delayed, early surgery is recommended. We encountered a rare case of ruptured fenestrated aneurysm of the vertebral artery (VA) union, treated it safely by endovascular surgery with Guglielmi detachable coils (GDCs) in the acute phase, and obtained a good outcome after intensive care.