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Review
. 2018 Sep 28:2018:bcr2018225625.
doi: 10.1136/bcr-2018-225625.

Perianeurysmal vasogenic oedema (PAVO) following aneurysm embolisation: a unique case of asymptomatic long-term progression and review of the literature

Anthony Ernest Robinson  1 , Constantine Chris Phatouros  2
Affiliations
Review

Perianeurysmal vasogenic oedema (PAVO) following aneurysm embolisation: a unique case of asymptomatic long-term progression and review of the literature

Anthony Ernest Robinson et al. BMJ Case Rep. .

Abstract

Perianeurysmal vasogenic oedema is a recognised although rare phenomenon following endovascular treatment of certain intracranial aneurysms. We present a unique case of asymptomatic perianeurysmal vasogenic oedema following bare platinum coil embolisation of an incidentally discovered right middle cerebral artery aneurysm that slowly increased over a period of 6 years before stabilising and regressing. During this time, the coiled aneurysm per se remained completely stable on serial magnetic resonance angiography.

Keywords: interventional radiology; neuroimaging.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Digital subtraction angiography demonstrated narrow-necked middle cerebral artery (M1 segment) aneurysm measuring 9.7 mm in diameter.
Figure 2
Figure 2
Postcoiling angiography demonstrated residual minor body filling. However, there was persistent intra-aneurysmal stasis of contrast (despite full systemic heparinisation and dual antiplatelet cover) from (A) early arterial, (B) early venous through to (C) late venous phase indicative of impending thrombosis.
Figure 3
Figure 3
T2-weighted axial MRI images 3 years post-treatment (A1–A5) and corresponding images 6 years post-treatment (B1–B5) demonstrating progressive perianeurysmal vasogenic oedema.
See this image and copyright information in PMC

References

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