ReviewNeurosurgery practice2025
Overcoming the Challenge of Distal Lenticulostriate Artery Aneurysms With Transarterial Embolization: Technical Insights, Case Series, and Literature Review.
Review in Neurosurgery practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
BACKGROUND AND
objectivesDistal lenticulostriate artery (LSA) aneurysms are rare but carry a high hemorrhage risk and are often associated with arteriovenous malformations or moyamoya disease. Their deep location and fragile, tortuous vessels pose significant challenges in transarterial embolization (TAE). This study integrates 3 institutional cases with a systematic literature review to identify key endovascular strategies.
methodsA literature review (1960-2024) identified 16 cases of distal LSA aneurysms treated with TAE, supplemented by our 3 institutional cases. Nineteen aneurysms were assessed for their clinical presentation, procedural details, complications, and outcomes. Seven TAE techniques, vasospasm management, cross-approach through the anterior communicating artery, balloon-assisted microcatheter navigation, use of distal access catheter, pre-embolization testing, targeted embolization, and rescue therapy, were evaluated for their roles in treating distal LSA aneurysms.
resultsAll 19 aneurysms were completely obliterated, with minor complications in 3 (15.8%) and no severe neurological deficits. No recurrences or rebleeding were observed over a mean follow-up period of 14.1 months. TAE, performed with these 7 techniques, demonstrated both safety and efficacy.
conclusionTAE represents a feasible and promising treatment for managing distal LSA aneurysms, providing favorable occlusion outcomes with relatively low risk of complications. The 7 described techniques serve as practical approaches to address the unique anatomic and hemodynamic challenges associated with distal LSA aneurysm embolization.
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