{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T07:12:45Z","timestamp":1778829165748,"version":"3.51.4"},"reference-count":21,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Neurosurgeons rarely encounter intracranial aneurysms involving the right aortic arch (RAA). We, herein, report a case of ruptured cerebral aneurysm with RAA treated with neuroendovascular therapy through direct carotid puncture (DCP) without complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Case Description:<\/jats:title>\n                    <jats:p>A 77-year-old woman was rushed to our hospital with sudden loss of consciousness. Computed tomography scan of the head showed Fisher group 3 subarachnoid hemorrhage. Three-dimensional computed tomography angiography showed a left internal carotid artery-posterior communicating artery aneurysm, and coil embolization was attempted. Intraoperative cerebral angiography revealed that RAA and the left common carotid artery (CCA) originated at an extremely acute angle from the cardiac base. Catheter guidance from both the femoral artery and brachial artery (BRA) were unsuccessful; therefore, coil embolization was performed through DCP. Using a 6Fr short sheath was placed in the CCA, and the surgery was completed using the balloon-assisted technique. The problem was uneventful with the stability of the balloon catheter or microcatheter during surgery. After surgery, the patient was transferred to a convalescent rehabilitation hospital with modified Rankin scale score of 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>When performing neuroendovascular therapy in patients with RAA, it is necessary to pay attention to the bifurcation position and angle of the target branching vessels and to consider the options for approaching, including DCP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_1103_2025","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:48:43Z","timestamp":1778827723000},"page":"278","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A case of left internal carotid artery-posterior communicating artery aneurysm with right aortic arch treated with coil embolization by direct carotid puncture"],"prefix":"10.25259","volume":"17","author":[{"given":"Daiji","family":"Ichihashi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunio","family":"Yokoyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naokado","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidekazu","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Kawanishi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"10.25259\/SNI_1103_2025\/ref-1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.25259\/SNI_1147_2021","article-title":"Direct carotid puncture for endovascular surgery of intracranial aneurysms: Technical note for avoiding complications","volume":"13","author":"Abe","year":"2022","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_1103_2025\/ref-2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s41984-025-00407-8","article-title":"The significance and impact of a rare finding of a right aortic arch during a neuro-endovascular intervention","volume":"40","author":"Belisha","year":"2025","journal-title":"Egypt J Neurosurg"},{"key":"10.25259\/SNI_1103_2025\/ref-3","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jvs.2003.07.021","article-title":"Kommerell\u2019s diverticulum and right-sided aortic arch: A cohort study and review of the literature","volume":"39","author":"Cina","year":"2004","journal-title":"J Vasc Surg"},{"key":"10.25259\/SNI_1103_2025\/ref-4","first-page":"47","article-title":"Transformation of the aortic-arch system during the development of the human embryo","volume":"14","author":"Congdon","year":"1922","journal-title":"Contrib Embryol Carnegie Inst Wash"},{"key":"10.25259\/SNI_1103_2025\/ref-5","doi-asserted-by":"crossref","first-page":"bcr2017222115","DOI":"10.1136\/bcr-2017-222115","article-title":"Successful embolisation of an intracranial meningioma via a right-sided aortic arch","volume":"2017","author":"Das","year":"2017","journal-title":"BMJ Case Rep"},{"key":"10.25259\/SNI_1103_2025\/ref-6","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/S0025-7125(16)35662-0","article-title":"Anomalies of the derivatives of the aortic arch system","volume":"32","author":"Edwards","year":"1948","journal-title":"Med Clin North Am"},{"key":"10.25259\/SNI_1103_2025\/ref-7","first-page":"137","article-title":"A case of coil embolization for the ruptured aneurysm with right-sided aortic arch","volume":"43","author":"Furukawa","year":"2021","journal-title":"J Stroke"},{"key":"10.25259\/SNI_1103_2025\/ref-8","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1136\/hrt.28.6.722","article-title":"Right-sided aorta. 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