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Aneurisma hiperdenso visualizado en el sitio de oclusión durante trombectomía: reporte de un caso
Ryosuke Kaneko1, Hiroyuki Ikeda1, Toshio Fujiwara1
1Department of Neurosurgery, Kurashiki Central Hospital, Okayama, JPN.
Cureus
|January 30, 2026
Resumen
Los aneurismas no reconocidos durante la trombectomía mecánica pueden ser un desafío. Una revisión cuidadosa de las tomografías computarizadas preoperatorias puede revelar signos hiperdensos sutiles, lo que ayuda en la detección de estas lesiones vasculares ocultas.
Área de la Ciencia:
- Neurología
- Cirugía Vascular
- Radiología
Sus antecedentes:
- La trombectomía mecánica es un tratamiento crítico para el accidente cerebrovascular por oclusión de grandes vasos.
- Los aneurismas no detectados representan un riesgo significativo durante los procedimientos endovasculares.
- La identificación preoperatoria de aneurismas distales a menudo es un desafío a pesar de las técnicas de imagen avanzadas.
Objetivo del estudio:
- Destacar el valor diagnóstico potencial de las tomografías computarizadas simples en la identificación de aneurismas previamente no reconocidos.
- Describir un caso en el que se sospechó un aneurisma intraoperatorio en la TC preoperatoria.
- Enfatizar la importancia de una revisión meticulosa de las imágenes preoperatorias en el tratamiento endovascular del accidente cerebrovascular.
Principales métodos:
- Reporte de caso de un hombre de 79 años con accidente cerebrovascular isquémico agudo.
- Análisis retrospectivo de las tomografías computarizadas preoperatorias.
- Descripción de los hallazgos intraoperatorios durante la trombectomía mecánica.
- Revisión de los aspectos técnicos del manejo del aneurisma durante la trombectomía.
Principales resultados:
- Se identificó un aneurisma no caracterizado intraoperatoriamente durante la trombectomía mecánica para la oclusión de la arteria carótida interna.
- La revisión retrospectiva reveló hallazgos hiperdensos preoperatorios en la TC sugestivos de un aneurisma.
- Se realizó una trombectomía exitosa, evitando el estrés mecánico sobre el aneurisma.
- El paciente logró una buena recuperación neurológica sin hemorragia intracraneal.
Conclusiones:
- Los hallazgos hiperdensos sutiles en la TC preoperatoria, que se desvían de la anatomía vascular normal, pueden indicar aneurismas ocultos.
- Una mayor vigilancia durante la revisión de las imágenes preoperatorias puede mejorar la detección de aneurismas antes de la trombectomía.
- El reconocimiento de estos signos puede prevenir complicaciones intraoperatorias y optimizar los resultados del paciente.
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