Transarterial embolization of ruptured distal choroidal artery aneurysm in Moyamoya disease: A case series and literature review.

BACKGROUND: Moyamoya disease (MMD) is characterized by the compensatory development of collateral vasculature. Aneurysm formation on collaterals is common. The rupture of these aneurysms is associated with a poor prognosis, which presents significant treatment challenges. CASE DESCRIPTION: We encountered two cases of distal choroidal artery aneurysm rupture in MMD. The first case experienced re-rupture and underwent superselective embolization. However, this case was complicated by an intraoperative rupture and subsequent hydrocephalus. The second case underwent parent artery occlusion without complications. CONCLUSION: These cases highlight both efficacy and the risks involved. Lesion accessibility is crucial. A careful evaluation of collaterals and precise planning are required.