Takayama Katsutoshi, Nakagawa Hiroyuki, Iwasaki Satoru, Taoka Toshiaki, Myouchin Kaoru, Wada Takeshi, Sakamoto Masahiko, Fukusumi Akio, Kurokawa Shinichiro, Kichikawa Kimihiko
Department of Interventional Neuroradiology, Ishinkai Yao General Hospital, 1-41 Numa, Yao 581-0036, Japan.
Radiat Med. 2008 Jan;26(1):33-8. doi: 10.1007/s11604-007-0184-9. Epub 2008 Jan 31.
The cerebrovascular complications of Takayasu arteritis are primarily related to the presence of occlusive lesions. Cerebral aneurysms rarely occur as complications; only 18 cases have been reported thus far. The use of coil embolization to treat cerebral aneurysms occurring as a complication of Takayasu arteritis has not been previously reported. We report a case of Takayasu arteritis with a basilar tip aneurysm and a P1 segment aneurysm of the left posterior cerebral artery that were successfully treated with coil embolization. Because coil embolization for cerebral aneurysms associated with Takayasu arteritis requires the use of limited access routes that have extremely curved and tortuous courses, catheter navigation was difficult. The guide catheter, microcatheter, and guidewire must be selected and navigated with greater care than is usually required for common aneurysm embolization.
大动脉炎的脑血管并发症主要与闭塞性病变的存在有关。脑动脉瘤作为并发症很少发生;迄今为止仅报道了18例。以往尚未报道使用弹簧圈栓塞治疗作为大动脉炎并发症出现的脑动脉瘤。我们报告1例大动脉炎患者,其基底动脉尖动脉瘤和左侧大脑后动脉P1段动脉瘤通过弹簧圈栓塞成功治疗。由于与大动脉炎相关的脑动脉瘤的弹簧圈栓塞需要使用路径极度弯曲和迂曲的有限入路,导管导航困难。与普通动脉瘤栓塞相比,必须更加小心地选择和操控导引导管、微导管和导丝。