Reproducción de aneurisma en tándem posterior a tratamiento quirúrgico en aneurisma de arteria comunicante anterior: reporte de caso

Abstract

Reproduction of aneurysms and their "'de novo" appearance after treatment is an unusually reported event, generally related to patient risk factors that favor this reproduction. Although the appearance of "de novo" aneurysms has been reported during patient follow-up and control, with an incidence between 0.1% and 0.5%, the report of aneurysms contiguous to previously treated lesions or in tandem has an unspecified incidence and their appearance is predominantly described in regions proximal to the treated aneurysm. However, there are pathophysiological factors that can modify the appearance of these lesions. In this case, we present a 43-year-old woman with hypoplasia of the A1 segment of the right anterior cerebral artery, a history of surgical correction of aortic coarctation and aneurysm of the anterior communicating artery, who underwent aneurysm clipping in August 2018 and subsequent outpatient follow-up confirming adequate exclusión of the aneurysmal lesion without residual neck of the aneurysm or additional vascular abnormalities. Two and a half years after the aneurysm clipping, the patient presented with meningitis, and control studies revealed a new aneurysmal lesion in the contiguous and distal anterior communicating artery to the clipped aneurysm, so the patient is being monitored for "de novo" aneurysmal lesion and in tandem.