Kusaka Noboru, Tamiya Takashi, Sugiu Kenji, Tokunaga Koji, Nishiguchi Mitsuhisa, Takayama Kazuhiro, Maeda Yasuhiko, Ogihara Kotaro, Nakagawa Minoru, Nishiura Tsukasa
Department of Neurosurgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Yamaguchi, Japan.
Neurol Med Chir (Tokyo). 2007 Jan;47(1):29-31. doi: 10.2176/nmc.47.29.
A 57-year-old female presented with a left petroclival meningioma fed by the meningohypophyseal trunk of the internal carotid artery (ICA). The enlarged tentorial marginal artery and inferior hypophyseal artery were successfully embolized with the TruFill DCS Detachable Coil System through a 0.019-inch inner diameter microcatheter. Superselective catheterization into the dorsal meningeal artery could not be achieved with the same microcatheter, because the catheter tip was too large to pass into the vessel. Subsequently the feeding artery was successfully embolized with a Guglielmi detachable coil (GDC) through a 0.016-inch inner diameter microcatheter. The patient underwent surgery without blood loss on the day after embolization. Our subjective impression was that the TruFill DCS was softer and had less resistance during insertion, whereas the GDC could be delivered through a smaller caliber system for smaller vessels. Appropriate use of the TruFill DCS and GDCs can allow efficient embolization of the feeding branches of the ICA.
一名57岁女性因左侧岩斜区脑膜瘤就诊,该肿瘤由颈内动脉(ICA)的脑膜垂体干供血。通过内径为0.019英寸的微导管,使用TruFill DCS可脱卸弹簧圈系统成功栓塞了增粗的小脑幕缘动脉和垂体下动脉。使用同一根微导管无法实现超选择性插管至脑膜背侧动脉,因为导管尖端太大无法进入该血管。随后,通过内径为0.016英寸的微导管使用Guglielmi可脱卸弹簧圈(GDC)成功栓塞了供血动脉。栓塞术后第二天,患者接受手术,术中无失血。我们的主观感受是,TruFill DCS更柔软,插入时阻力更小,而GDC可通过更小口径的系统用于更细的血管。合理使用TruFill DCS和GDC可实现ICA供血分支的有效栓塞。