Skull Base 2010; 20(6): 405-408
DOI: 10.1055/s-0030-1253578
ORIGINAL ARTICLE

© Thieme Medical Publishers

De Novo Aneurysm Formation after Carotid Artery Occlusion for Cerebral Aneurysms

Priyangee K. Arambepola1 , Sean D. McEvoy2 , Ketan R. Bulsara2
  • 1Department of Radiology, Sri Jayewardenepura General Hospital, Kotte, Sri Lanka
  • 2Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut
Further Information

Publication History

Publication Date:
27 April 2010 (online)

ABSTRACT

Therapeutic parent artery occlusion has been routinely utilized for management of some intracranial aneurysms. One possible long-term complication of this procedure is “de novo” formation of aneurysms. The purpose of this paper is to estimate the incidence of de novo aneurysm formation, the time period between occlusion and formation, and the most common sites of formation. A PubMed search was performed for all articles between 1970 and 2008 reporting cases of both therapeutic carotid occlusion and de novo cerebral aneurysms. The 20 papers reviewed reported 187 patients having undergone therapeutic carotid occlusion. Of the 163 patients reported in complete-case series, seven developed new aneurysms (4.3%). Thirty-six total new aneurysms were reported, ranging from 1 to 5 per patient. The average time period between occlusion and detection of de novo aneurysm was 9.1 years (range: 2 to 20 years). These aneurysms occurred mostly in the anterior circulation, predominately the anterior communicating artery and posterior communicating artery, and frequently occurred contralateral to the site of occlusion. Therapeutic parent artery occlusion is a likely risk factor for de novo aneurysm formation. Noninvasive follow-up studies should be performed, especially between 2 and 10 years after occlusion.

REFERENCES

  • 1 Niiro M, Shimozuru T, Nakamura K, Kadota K, Kuratsu J. Long-term follow-up study of patients with cavernous sinus aneurysm treated by proximal occlusion.  Neurol Med Chir (Tokyo). 2000;  40(2) 88-96 discussion 96-97
  • 2 Timperman P E, Tomsick T A, Tew Jr J M, van Loveren H R. Aneurysm formation after carotid occlusion.  AJNR Am J Neuroradiol. 1995;  16(2) 329-331
  • 3 Roski R A, Spetzler R F, Nulsen F E. Late complications of carotid ligation in the treatment of intracranial aneurysms.  J Neurosurg. 1981;  54(5) 583-587
  • 4 Winn H R, Richardson A E, Jane J A. Late morbidity and mortality of common carotid ligation for posterior communicating aneurysms. A comparison to conservative treatment.  J Neurosurg. 1977;  47(5) 727-736
  • 5 Kim H, Jung J Y, Lee J W, Huh S K, Lee K C. A clinical analysis of twelve cases of ruptured cerebral de novo aneurysms.  Yonsei Med J. 2007;  48(1) 30-34
  • 6 Matheus M G, Castillo M. Development of de novo intracranial aneurysm in three months: case report and literature review.  AJNR Am J Neuroradiol. 2003;  24(4) 709-710
  • 7 Obray R, Clatterbuck R, Olvi A, Tamargo R, Murphy K J, Gailloud P. De novo aneurysm formation 6 and 22 months after initial presentation in two patients.  AJNR Am J Neuroradiol. 2003;  24(9) 1811-1813
  • 8 Lylyk P, Miranda C, Ceratto R et al.. Curative endovascular reconstruction of cerebral aneurysms with the pipeline embolization device: the Buenos Aires experience.  Neurosurgery. 2009;  64(4) 632-642, discussion 642–643, quiz N6
  • 9 Fiorella D, Lylyk P, Szikora I et al.. Curative cerebrovascular reconstruction with the Pipeline embolization device: the emergence of definitive endovascular therapy for intracranial aneurysms.  J Neurointerv Surg. 2009;  1 56-65
  • 10 Klemme W M. Hemorrhage from a previously undemonstrated intracranial aneurysm as a late complication of carotid artery ligation. Case report.  J Neurosurg. 1977;  46(5) 654-658
  • 11 Salar G, Mingrino S. Development of intracranial saccular aneurysms: report of two cases.  Neurosurgery. 1981;  8(4) 462-465
  • 12 Clark W C, Ray M W. Contralateral intracranial aneurysm formation as a late complication of carotid ligation.  Surg Neurol. 1982;  18(6) 458-462
  • 13 Ostergaard J R. A long-term follow-up study of juvenile aneurysm patients.  Acta Neurochir (Wien). 1985;  77(3–4) 103-109
  • 14 Dyste G N, Beck D W. De novo aneurysm formation following carotid ligation: case report and review of the literature.  Neurosurgery. 1989;  24(1) 88-92
  • 15 Heros R C. Comment on: Dyste GN, Beck DW. De novo aneurysm formation following carotid ligation: case report and review of the literature.  Neurosurgery. 1989;  24 92
  • 16 Drapkin A J, Rose W S. Serial development of ‘de novo’ aneurysms after carotid ligation: case report.  Surg Neurol. 1992;  38(4) 302-308
  • 17 Fujiwara S, Fujii K, Fukui M. De novo aneurysm formation and aneurysm growth following therapeutic carotid occlusion for intracranial internal carotid artery (ICA) aneurysms.  Acta Neurochir (Wien). 1993;  120(1-2) 20-25
  • 18 Yoshimura S, Nishimura Y, Andoh T, Sakai N, Yamada H. Giant serpentine aneurysm followed up for more than 10 years: report of a case and review of the literature.  No Shinkei Geka. 1994;  22(2) 179-183
  • 19 Ladziński P, Majchrzak H, Machowski J, Lech A. Aneurysm of the anterior communicating artery as a possible late complication of internal carotid artery ligation.  Neurol Neurochir Pol. 1994;  28(6) 933-938
  • 20 Parekh H C, Prabhu S S, Keogh A J. De novo development of saccular aneurysms: report of two cases.  Br J Neurosurg. 1995;  9(5) 695-698
  • 21 Maiuri F, Spaziante R, Iaconetta G, Signorelli F, Cirillo S, Di Salle F. ‘De novo’ aneurysm formation: report of two cases.  Clin Neurol Neurosurg. 1995;  97(3) 233-238
  • 22 Ogasawara K, Numagami Y, Kitahara M. A case of ruptured true posterior communicating artery aneurysm thirteen years after surgical occlusion of the ipsilateral cervical internal carotid artery.  No Shinkei Geka. 1995;  23(4) 359-363
  • 23 Johnston S C, Halbach V V, Smith W S, Gress D R. Rapid development of giant fusiform cerebral aneurysms in angiographically normal vessels.  Neurology. 1998;  50(4) 1163-1166
  • 24 Briganti F, Cirillo S, Caranci F, Esposito F, Maiuri F. Development of “de novo” aneurysms following endovascular procedures.  Neuroradiology. 2002;  44(7) 604-609
  • 25 Wolf R L, Imbesi S G, Galetta S L, Hurst R W, Sinson G P, Grossman R I. Development of a posterior cerebral artery aneurysm subsequent to occlusion of the contralateral internal carotid artery for giant cavernous aneurysm.  Neuroradiology. 2002;  44(5) 443-446

Ketan R BulsaraM.D. 

Department of Neurosurgery, Yale University School of Medicine

PO Box 208082, New Haven, CT 06520

Email: ketan.bulsara@yale.edu

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