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双支架置入法:小型宽颈动脉瘤的治疗选择。技术说明。

Double-stent method: therapeutic alternative for small wide-necked aneurysms. Technical note.

作者信息

Doerfler Arnd, Wanke Isabel, Egelhof Thomas, Stolke Dietmar, Forsting Michael

机构信息

Department of Neuroradiology, Institute of Diagnostic and Interventional Radiology, University of Essen Medical School, Essen, Germany.

出版信息

J Neurosurg. 2004 Jan;100(1):150-4. doi: 10.3171/jns.2004.100.1.0150.

Abstract

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.

摘要

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。

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