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Cornelissen SA, Heye S, Maleux G, et al. Treatment of ruptured subclavian steal flow-related vertebrobasilar junction aneurysms: Case report on surgical and endovascular considerations from two cases. Int J Surg Case Rep. 2021;90:106744doi: 10.1016/j.ijscr.2021.106744.
Cornelissen, S. A., Heye, S., Maleux, G., Daenens, K., van Loon, J., & De Vleeschouwer, S. (2022). Treatment of ruptured subclavian steal flow-related vertebrobasilar junction aneurysms: Case report on surgical and endovascular considerations from two cases. International journal of surgery case reports, 90106744. https://doi.org/10.1016/j.ijscr.2021.106744
Cornelissen, Sandra Adriana, et al. "Treatment of ruptured subclavian steal flow-related vertebrobasilar junction aneurysms: Case report on surgical and endovascular considerations from two cases." International journal of surgery case reports vol. 90 (2022): 106744. doi: https://doi.org/10.1016/j.ijscr.2021.106744
Cornelissen SA, Heye S, Maleux G, Daenens K, van Loon J, De Vleeschouwer S. Treatment of ruptured subclavian steal flow-related vertebrobasilar junction aneurysms: Case report on surgical and endovascular considerations from two cases. Int J Surg Case Rep. 2022 Jan;90:106744. doi: 10.1016/j.ijscr.2021.106744. Epub 2021 Dec 30. PMID: 34991048; PMCID: PMC8741505.
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Int J Surg Case Rep. 2022 Jan;90:106744. doi: 10.1016/j.ijscr.2021.106744. Epub 2021 Dec 30.

Treatment of ruptured subclavian steal flow-related vertebrobasilar junction aneurysms: Case report on surgical and endovascular considerations from two cases.

International journal of surgery case reports

Sandra Adriana Cornelissen, Sam Heye, Geert Maleux, Kim Daenens, Johannes van Loon, Steven De Vleeschouwer

Affiliations

  1. Department of Radiology, University Hospitals Leuven, Leuven, Belgium(1); Department of Neuroradiology, Erasmus MC, Rotterdam, the Netherlands(2).
  2. Department of Radiology, University Hospitals Leuven, Leuven, Belgium(1); Department of Radiology, Jessa Ziekenhuis, Hasselt, Belgium(2). Electronic address: [email protected].
  3. Department of Radiology, University Hospitals Leuven, Leuven, Belgium(1). Electronic address: [email protected].
  4. Department of Vascular Surgery, University Hospitals Leuven, Leuven, Belgium. Electronic address: [email protected].
  5. Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium. Electronic address: [email protected].
  6. Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium. Electronic address: [email protected].

PMID: 34991048 PMCID: PMC8741505 DOI: 10.1016/j.ijscr.2021.106744

Abstract

INTRODUCTION: Subclavian steal phenomenon causes retrograde flow through the vertebral artery, ipsilateral to the affected subclavian artery, which rarely leads to flow-related vertebrobasilar junction (VBJ) aneurysms.

CASE DESCRIPTIONS: We describe two cases of subarachnoid hemorrhage from such ruptured aneurysms in which the retrograde flow direction in the vertebral artery complicated surgical and endovascular treatment.

DISCUSSION: Reversed flow in the vertebral artery, ipsilateral to the stenotic subclavian artery leads to a lack of proximal control in surgical clipping of these VBJ aneurysms and jeopardizes stability of coil and stent placement in endovascular aneurysm treatments in this setting.

CONCLUSION: From these 2 experiences over 7 years, treatment considerations emerged for future cases.

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords: Case report; Endovascular procedure; Intracranial aneurysm; Neurosurgical clipping; Subarachnoid hemorrhage; Subclavian steal syndrome

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