Treatment of Supraophthalmic Internal Carotid Artery Fenestration with an Associated Aneurysm via Flow Diversion: A Case Report

Johannes Kasper,1 Ulf Nestler,1 Jürgen Meixensberger,1 Ulf Quäschling2 1Department of Neurosurgery, University Hospital Leipzig, Leipzig, 04103, Germany; 2Institute of Neuroradiology, Department of Diagnostic Medicine, University Hospital Leipzig, Leipzig, 04103, GermanyCorrespondence: Johannes KasperDepartment of Neurosurgery, University Hospital Leipzig, Liebigstraße 20, Leipzig, 04103, GermanyTel +49 3419717892Fax +49 3419717509Email Johannes.Kasper@medizin.uni-leipzig.deAbstract: Cerebral artery fenestration with flow-associated aneurysm is rare among cerebrovascular pathologies. Treatment includes open neurosurgery and/or endovascular treatment. We report a case of a 53-year-old woman with an incidentally detected aneurysm during magnetic resonance tomography. As the underlying cause, a digital subtraction angiography revealed a left internal carotid artery fenestration. Elective endovascular treatment via flow diversion was indicated and a pipeline embolization device was implanted. Follow-up examinations presented a completely occluded additional caudal limb and a decreasing aneurysm size. No clinically adverse events occurred within twenty-four-month post-treatment. Therefore, sole flow diversion was a feasible treatment option in this case.Keywords: fenestrated cerebral artery, cavernous aneurysm, flow diversion, pipeline device