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支架辅助弹簧圈栓塞治疗宽颈肾动脉分叉部动脉瘤。

Stent-assisted coil embolization of wide-necked renal artery bifurcation aneurysms.

作者信息

Manninen Hannu I, Berg Marja, Vanninen Ritva L

机构信息

Department of Clinical Radiology, Kuopio University Hospital and Kuopio University, Kuopio, Finland.

出版信息

J Vasc Interv Radiol. 2008 Apr;19(4):487-92. doi: 10.1016/j.jvir.2007.10.026.

Abstract

PURPOSE

To report preliminary results of stent-assisted coil embolization in the treatment of wide-necked renal artery bifurcation aneurysms.

MATERIALS AND METHODS

Four patients (three women, one man; mean age, 54 years; range, 49-67 y) with wide-necked renal artery aneurysms were treated with dedicated neurointerventional self-expanding nitinol stent-assisted coil embolization during a 2-year period. The stent was delivered over the neck of the aneurysm, after which the aneurysm was filled with detachable coils through a microcatheter placed into the aneurysm through the stent mesh.

RESULTS

Stent delivery and coil embolization was successfully completed in all cases. Complete aneurysm occlusion without coil protrusion or arterial flow compromise was obtained in all patients. A small peripheral subsegmental renal infarction necessitating no therapy was registered in one patient on postembolization computed tomography. At follow-up angiography 1 year after embolization, no aneurysm recanalization or arterial obstruction was registered.

CONCLUSIONS

Our preliminary experience indicates that stent-assisted coil embolization is technically feasible and effective for the exclusion of challenging renal artery bifurcation aneurysms without the sacrifice of any branch arteries.

摘要

目的

报告支架辅助弹簧圈栓塞术治疗宽颈肾动脉分叉动脉瘤的初步结果。

材料与方法

在2年期间,对4例(3例女性,1例男性;平均年龄54岁;范围49 - 67岁)宽颈肾动脉动脉瘤患者采用专用神经介入自膨式镍钛合金支架辅助弹簧圈栓塞术进行治疗。将支架放置在动脉瘤颈部上方,然后通过经支架网眼置入动脉瘤内的微导管,用可脱卸弹簧圈填充动脉瘤。

结果

所有病例均成功完成支架置入和弹簧圈栓塞。所有患者均实现动脉瘤完全闭塞,无弹簧圈突出或动脉血流受损。栓塞后计算机断层扫描显示1例患者出现小的外周亚节段性肾梗死,无需治疗。栓塞后1年的随访血管造影显示,无动脉瘤再通或动脉阻塞。

结论

我们的初步经验表明,支架辅助弹簧圈栓塞术在技术上是可行的,对于排除具有挑战性的肾动脉分叉动脉瘤有效,且无需牺牲任何分支动脉。

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