Case reportRuptured choroidal artery aneurysms in patients with moyamoya disease: Two case series and review of the literatures

- MMD-associated distal peripheral artery aneurysms have a high tendency to rupture and therefore, require prompt treatment.
- Direct obliteration of aneurysms has particular challenges due to their deep location, small size, and fragility.
- Annual follow-up DSA for surveillance of hemodynamic status is necessary and endovascular treatment is a proper treatment for these aneurysms.

Distal peripheral artery aneurysms in moyamoya disease (MMD) remain difficult to treat given their deep location, small size, and fragility. Here, we report two cases of choroidal artery aneurysms associated with MMD who were treated through direct clipping and coil embolization. Timing of aneurysm formation remains unclear, however, annual follow-up DSA for surveillance of hemodynamic status is necessary and prompt treatment of aneurysm should be performed when diagnosed. Moreover, choroidal artery aneurysms may benefit from endovascular coil embolization due to their characteristics.