A rare pattern of aneurysm growth: A case report and literature review

Abstract

Intracranial aneurysm recurrence remains a significant challenge in neurovascular care. This study presents a unique case of multiple aneurysms merging into a single, dominant aneurysm post-treatment, diverging from conventional growth patterns. This pattern potentially challenges existing beliefs about aneurysm development and suggests the influence of specific hemodynamic factors. Our findings from this case point to an increased risk of aneurysm growth in regions characterized by low wall shear stress (WSS) and high oscillatory shear index (OSI). To manage the recurrent aneurysm and prevent further recurrence, we successfully employed a pipeline embolization device (PED). Short-term follow-up assessments showed no aneurysm recurrence. This case underscores the potential impact of specific hemodynamic factors on intracranial aneurysm development and growth patterns. It emphasizes the importance of considering hemodynamics in personalized treatment approaches. Additionally, the utilization of the PED may offer an effective means of addressing large kissing aneurysms. Further research in this area is warranted to enhance our understanding of aneurysm recurrence and refine treatment approaches for kissing aneurysms for improved patient outcomes.