Doerfler Arnd, Wanke Isabel, Egelhof Thomas, Stolke Dietmar, Forsting Michael
Department of Neuroradiology, Institute of Diagnostic and Interventional Radiology, University of Essen Medical School, Essen, Germany.
J Neurosurg. 2004 Jan;100(1):150-4. doi: 10.3171/jns.2004.100.1.0150.
The authors present two cases of patients with small, acutely ruptured, wide-necked aneurysms of the distal vertebral artery that were not amenable to conventional coil embolization and were instead treated by means of a double-stent method in which one stent was placed inside another. Angiography performed immediately after the procedure revealed a significant reduction in aneurysm filling; total occlusion of the lesion was observed after 7 days and confirmed 6 months later in both aneurysms. By placing one stent inside the other, stent permeability can be reduced, which may result in significant hemodynamic changes with accelerated aneurysm thrombosis. This double-stent method may represent a therapeutic alternative, especially in cases of small, wide-necked aneurysms in which conventional endovascular techniques or stent-supported coil embolization is not considered feasible or is believed to be too dangerous, and surgical treatment is contra-indicated.
作者介绍了两例远端椎动脉小型急性破裂宽颈动脉瘤患者,这些动脉瘤不适于传统的弹簧圈栓塞治疗,而是采用双支架方法进行治疗,即将一个支架置于另一个支架内。术后立即进行的血管造影显示动脉瘤充盈明显减少;7天后观察到病变完全闭塞,6个月后两个动脉瘤均得到证实。通过将一个支架置于另一个支架内,可以降低支架的通透性,这可能导致显著的血流动力学变化,加速动脉瘤血栓形成。这种双支架方法可能是一种治疗选择,特别是对于小型宽颈动脉瘤,在这些病例中,传统的血管内技术或支架辅助弹簧圈栓塞被认为不可行或过于危险,且手术治疗为禁忌。