Flow Diversion for Treatment of Growing A2 Aneurysm in a Child: Case Report and Review of Flow Diversion for Intracranial Aneurysms in Pediatric Patients

• Published in: World neurosurgery Vol. 96; pp. 607.e13 - 607.e17
• Main Authors: Vachhani, Jay, MD, Nickele, Christopher, MD, Elijovich, Lucas, MD, Klimo, Paul, MD, MPH, Arthur, Adam S., MD, MPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2016
• Subjects: Aneurysm; Angiography, Digital Subtraction; Cerebral Angiography; Child; Embolization, Therapeutic - instrumentation; Female; Flow diversion; Follow-Up Studies; Humans; Imaging, Three-Dimensional; Intracranial; Intracranial Aneurysm - diagnosis; Intracranial Aneurysm - surgery; Magnetic Resonance Angiography; Neurosurgery; Pediatric; Postoperative Complications - diagnosis; Stents; Intracranial; Glasgow Outcome Score; magnetic resonance imaging; Anterior Cerebral Artery; MRI; Aneurysm; KID; GOS; Flow Diversion; Kids’ Inpatient Database; PED; mRS; PA; magnetic resonance angiogram; Pipeline Embolization Device; Posterior-Anterior; Pediatric; MRA; ACA; modified Rankin Scale score; Flow diversion
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2016.09.078

Abstract Intracranial flow diversion has gained increasing popularity since the approval of the Pipeline Embolization Device (PED). Although it is only approved for use in adult patients, the PED has been used to treat aneurysms in pediatric patients. We present the first reported case of the use of a PED in a pediatric patient to treat an unusual fusiform distal anterior cerebral artery aneurysm. A 12-year-old female presented with new onset seizures and was found to have an incidental distal left anterior cerebral artery aneurysm. Initially, this was managed conservatively, but follow-up imaging performed 4 months after presentation demonstrated enlargement of the aneurysm. The patient underwent endovascular embolization of her aneurysm with a Pipeline Embolization Device. This was successfully performed and the patient recovered from the procedure with no neurologic deficits. Follow-up digital subtraction angiography and magnetic resonance angiography at 6 and 12 months, respectively, showed complete occlusion of the aneurysm. The authors also reviewed the literature on flow diversion for treatment of pediatric intracranial aneurysms.