Citation

Oishi H, Mishima Y, Yatomi K, Teranishi K, Suzuki K, Fujii T. NMC Case Rep. J. 2021; 8(1): 33-37.

Copyright

(Copyright © 2021, Japan Neurosurgical Society)

DOI

10.2176/nmccrj.cr.2020-0107

PMID

34012746

PMCID

PMC8116919

Abstract

The authors report a rare autopsy case. A 59-year-old woman underwent flow diverter (FD) therapy using a pipeline embolization device (PED) for a large paraclinoid internal carotid artery aneurysm. Follow-up magnetic resonance (MR) examinations were performed 6 months after the treatment. Although the T2-weighted images showed progressive thrombosis of the aneurysm, the silent MR angiography (MRA) clearly showed the residual blood flow within the aneurysm. The patient committed suicide 2 months after the follow-up MR examinations. An autopsy specimen showed a small section of the defective membranes with the PED that matched the entry point of residual blood flow seen clearly in the silent MRA. Macroscopic photograph and hematoxylin and eosin stained sections showed defective endothelialization. In contrast, complete endothelialization was observed in membranes covering the PED. The autopsy findings after FD therapy showed defective endothelialization that perfectly matched and corroborated the silent MRA findings.

Language: en

Keywords

autopsy; endothelialization; flow diverter therapy; pipeline embolization device