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经血管线圈钩取术取出松解的 Guglielmi 可脱卸线圈:技术说明

Transvascular coil hooking procedure to retrieve an unraveled Guglielmi detachable coil: technical note.

作者信息

Raftopoulos Christian, Goffette Pierre, Billa Rudolf F, Mathurin Pierre

机构信息

Department of Neurosurgery, St.-Luc Hospital, Université Catholique de Louvain, Brussels, Belgium.

出版信息

Neurosurgery. 2002 Apr;50(4):912-4; discussion 914-5. doi: 10.1097/00006123-200204000-00048.

Abstract

OBJECTIVE

A patient with an anterior communicating artery aneurysm was treated by use of endovascular coiling, and a Guglielmi detachable coil (Boston Scientific/Target, Fremont, CA) fractured distal to its connection to the delivering catheter. The unraveled coil floated out from the aneurysm to extend into the bifurcation of the left middle cerebral artery. We describe the microsurgical procedure used to retrieve the coil after an endovascular approach failed.

METHODS

The left anterior cerebral artery was punctured just below the aneurysm neck, and a titanium microhook was introduced to anchor the coil and pull it out. Slight traction was exerted before sectioning the coil to avoid protrusion of the stump into the parent vessel.

RESULTS

The unraveled coil was removed in totality without permanent morbidity.

CONCLUSION

This report describes the case of a rare complication of coil embolization treated with a minimal transarterial coil hooking procedure.

摘要

目的

一名前交通动脉瘤患者接受了血管内栓塞治疗,使用的 Guglielmi 可脱卸弹簧圈(波士顿科学公司/Target,弗里蒙特,加利福尼亚州)在其与输送导管连接处的远端发生断裂。松开的弹簧圈从动脉瘤中漂浮出来,延伸至左大脑中动脉分叉处。我们描述了在血管内治疗方法失败后用于取出弹簧圈的显微外科手术过程。

方法

在动脉瘤颈部下方穿刺左大脑前动脉,插入一个钛制微型钩以固定弹簧圈并将其拉出。在切断弹簧圈之前施加轻微牵引力,以避免残端突入母血管。

结果

松开的弹簧圈被全部取出,未留下永久性后遗症。

结论

本报告描述了通过最小限度的经动脉弹簧圈钩取术治疗弹簧圈栓塞罕见并发症的病例。

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