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新一代血流导向装置治疗儿童海绵窦颈动脉感染性动脉瘤:病例报告。

Infectious aneurysm of the cavernous carotid artery in a child treated with a new-generation of flow-diverting stent graft: case report.

机构信息

Department of Neuroradiology, Hôpital Roger Salengro, University Hospital Lille, Lille, France.

出版信息

Neurosurgery. 2010 Mar;66(3):E623-4; discussion E624. doi: 10.1227/01.NEU.0000365370.82554.08.

Abstract

OBJECTIVE

To report a unique case of wide-necked mycotic cerebral aneurysm treated with a new generation of intracranial stent.

CLINICAL PRESENTATION

A 10-year-old girl presented with meningitis complicated by an infectious intracavernous large aneurysm revealed by cranial nerve palsy.

INTERVENTION

The aneurysm was treated by a new-generation, flow-diverting, endoluminal implant (SILK; BALT EXTRUSION, Montmorency, France) placed across the aneurysm neck without coiling. Angiographic controls showed complete thrombosis of the aneurysmal sac with dramatic improvement of symptoms a couple of weeks after the procedure. Follow-up magnetic resonance imaging and digital subtraction angiography 3 months after the procedure, confirmed total occlusion of the aneurysm with normal circulation in the parent vessel

CONCLUSION

This is a simple and highly effective way to exclude an aneurysm from the parent vessel without the difficulties observed with the semi-rigid stents. Flow-disrupting stent grafting may be a safe and effective alternative treatment for large intracranial aneurysms.

摘要

目的

报告一例采用新一代颅内支架治疗宽颈真菌性脑动脉瘤的独特病例。

临床特征

一名 10 岁女孩因脑膜炎并发感染性海绵窦大型动脉瘤导致颅神经麻痹而就诊。

干预措施

采用新一代血流导向、腔内植入物(SILK;BALT EXTRUSION,蒙莫朗西,法国)治疗动脉瘤,该植入物横跨动脉瘤颈部放置,未进行线圈填塞。血管造影检查显示动脉瘤囊完全血栓形成,术后数周症状明显改善。术后 3 个月行磁共振成像和数字减影血管造影随访,证实动脉瘤完全闭塞,载瘤动脉循环正常。

结论

与半刚性支架相比,这种方法可简单、高效地将动脉瘤从载瘤动脉中排除,血流阻断支架移植物可能是治疗大型颅内动脉瘤的一种安全有效的替代方法。

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