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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Related Experiment Video

Updated: May 5, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Delayed Rupture from a Pseudoaneurysm after Mechanical Thrombectomy: A Case Report.

Yukinori Takase1, Tatsuya Tanaka1,2, Hirofumi Goto3

  • 1Department of Neurosurgery, Kouhoukai Takagi Hospital, Okawa, Japan.

Asian Journal of Neurosurgery
|August 29, 2024
PubMed
Summary

Pseudoaneurysm after mechanical thrombectomy (MT) can rupture late. This case highlights delayed rupture of a pseudoaneurysm post-MT, emphasizing the need for imaging surveillance after subarachnoid hemorrhage during the procedure.

Keywords:
acute ischemic strokecomplicationmechanical thrombectomypseudoaneurysmstent retrieversubarachnoid hemorrhagevessel perforation

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Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Vascular Surgery

Background:

  • Mechanical thrombectomy (MT) is a key treatment for acute ischemic stroke.
  • Pseudoaneurysms are rare but serious complications of endovascular procedures.
  • Stent retrievers are commonly used in MT, carrying potential risks.

Observation:

  • An 85-year-old woman developed hemiplegia and aphasia due to left middle cerebral artery M2 occlusion.
  • During MT with a stent retriever, microcatheter manipulation caused vessel perforation and subarachnoid hemorrhage (SAH).
  • Initial management included balloon occlusion, anticoagulation reversal, and blood pressure control.

Findings:

  • Follow-up imaging 14 days post-MT revealed a pseudoaneurysm at the perforation site, which had ruptured, causing a massive hematoma.
  • Open surgery was required to surgically clip the ruptured artery.
  • This case demonstrates a delayed rupture of a pseudoaneurysm following MT.

Implications:

  • Subarachnoid hemorrhage during MT warrants vigilant follow-up imaging to detect pseudoaneurysm formation.
  • Early identification and management of pseudoaneurysms post-MT are crucial to prevent catastrophic rupture.
  • Consideration of advanced imaging like CT angiography or MR angiography is recommended after MT if SAH is noted.