Weber W, Henkes H, Kühne D
Klinik für Radiologie und Neuroradiologie, Alfried Krupp Krankenhaus, Essen.
Nervenarzt. 2000 Oct;71(10):843-8. doi: 10.1007/s001150050674.
In aneurysms with a neck:dome ratio of 1:2 or more or with a wide neck, endovascular treatment is less effective. In this situation, the rate of thrombotic and thromboembolic complications is increased. Recently available highly flexible balloon expandable coronary stents improved the technique of endovascular aneurysm treatment. Two patients with wide neck midbasilar aneurysms were successfully treated endovascularly using a combination of stent deployment into the basilar artery and coil occlusion of the aneurysm. The creation of an artificial boundary between a side wall aneurysm and the parent artery by stent deployment improves the conditions for subsequent coil occlusion of the aneurysm. If, after detachment, coils protrude from the lumen of a side wall aneurysm into the parent vessel, stenting of this vessel can prevent thrombotic and thromboembolic complications.
对于瘤颈与瘤体比例为1:2或更大的动脉瘤或宽颈动脉瘤,血管内治疗效果较差。在这种情况下,血栓形成和血栓栓塞并发症的发生率会增加。最近可用的高柔韧性球囊扩张式冠状动脉支架改进了血管内动脉瘤治疗技术。两名患有宽颈基底动脉中段动脉瘤的患者通过将支架置入基底动脉并结合动脉瘤的弹簧圈栓塞成功地进行了血管内治疗。通过置入支架在侧壁动脉瘤与载瘤动脉之间建立人工边界,改善了后续动脉瘤弹簧圈栓塞的条件。如果在解脱后,弹簧圈从侧壁动脉瘤腔突入载瘤血管,对该血管进行支架置入可预防血栓形成和血栓栓塞并发症。