THROMBOSED GROWING GIANT ANEURYSMS OF THE VERTEBRAL ARTERY - GROWTH-MECHANISM AND MANAGEMENT

Results in three patients with thrombosed giant aneurysms of the verte bral artery are reported. Each of the aneurysms presented as a mass le sion. On postcontrast computerized tomography and magnetic resonance i maging, each aneurysm demonstrated a patent lumen and intrathrombotic vascular channels. Two patients died and were autopsied, and the other patient was successfully treated. Pathological examination revealed t hat the aneurysms had staged clots, an open lumen, intrathrombotic cha nnels with endothelial lining, and aneurysmal walls with intimal thick ening. The authors suggest that the development of the intrathrombotic capillary channels may be an important factor in the growth of thromb osed giant aneurysm of the vertebral artery. Trapping of the aneurysm followed by aneurysmectomy appears to be the best treatment for this t ype of aneurysm.