Abstract WP90: Immunohistochemical Analysis Of A Ruptured Basilar Top Aneurysm Treated With Coil Embolization In 1990
Purpose: A ruptured basilar top aneurysm was treated with pre-market GDC in 1990. The fourteenth patient since the initial clinical use of the GDC survived the subarachnoid hemorrhage and deceased in 2012 due to unrelated medical condition. Immunohistochemical analysis of the aneurysm was performed.
Materials and Methods: A 61 year old female who suffered SAH due to a ruptured basilar top aneurysm majoring 6mm in largest diameter was treated with GDC in 1990. The patient survived the SAH without any neurological deficit, and the last angiogram performed in 1996 showed complete obliteration. The patient recently deceased in 2012 due to unrelated medical condition, and autopsy was performed. The aneurysm was removed with the surrounding tissue, fixed and embedded in paraffin. Histologic analysis using H&E staining, Masson Trichrome staining, alfa smooth muscle actine (αSMA) staining as well as factor VIII staining was performed.
Results: The gross findings showed no adhesion between the treated aneurysm and the adjacent brain tissue. The orifice of the aneurysm was completely covered by a layer of neointima, and patency of bilateral P1 perforators was confirmed. Microscopic findings showed a prominent collagen deposition with minimal cellular component in the aneurysm. A thick layer of neointima covering the orifice of the aneurysm was composed of a layer of thick collagenous tissue and a layer of SMA positive sub intimal tissue. There was no major histologic change observed in the adjacent brain tissue such as cerebral peduncles.
Conclusion: A histologic / immunohistochemical analysis of a ruptured basilar top aneurysm which was treated 22 years ago was performed. A neointima covering the orifice of the aneurysm was composed of a thick layer of collagenous tissue and a layer of SMA positive subintimal tissue. Patency of the perforating arteries from the bilateral P1 segment was confirmed, and no major histologic change was seen in the adjacent brain tissue.
- © 2012 by American Heart Association, Inc.