Liu L, Jiang C, He H, Li Y, Wu Z
Beijing Neurosurgical Institute, Tiantan Hospital, Capital Medical University, Beijing, China.
Interv Neuroradiol. 2010 Mar;16(1):77-82. doi: 10.1177/159101991001600110. Epub 2010 Mar 25.
A 30-year-old man was referred in our department for treatment of a midbasilar trunk aneurysm. His presenting symptoms included headache and dizziness. A CT scan at another hospital showed no significant findings whereas a digital subtraction angiogram disclosed a dissecting aneurysm in the midbasilar trunk, and there was severe stenosis in the basilar artery. After discussion, we planned to use stent-assisted-coil embolization technique. During the procedure, a LEO stent (Balt, Montmorency, France) was implanted into the basilar artery across the aneurysm neck, but fearing acute basilar artery occlusion because of stent collapse or thrombus we did not fill coils into the aneurysm. After the procedure, the completion angiography demonstrated considerably decreased flow into the aneurysm, with stasis persisting into the venous phase of angiography. The patient awoke from general anaesthesia after the procedure and had no additional neurological symptoms, he was discharged three days later and used clopidogrel and aspirin for antiplatelet therapy. Six months later when he was admitted for a recheck, a DSA showed the basilar artery was occluded completely and the aneurysm had disappeared even though the patient remained neurologically normal.
一名30岁男性因基底动脉中段动脉瘤被转诊至我科治疗。他的主要症状包括头痛和头晕。另一家医院的CT扫描未发现明显异常，而数字减影血管造影显示基底动脉中段有一个夹层动脉瘤，且基底动脉存在严重狭窄。经过讨论，我们计划采用支架辅助弹簧圈栓塞技术。手术过程中，一枚LEO支架（法国巴尔的摩市蒙莫朗西的Balt公司生产）经动脉瘤颈部植入基底动脉，但由于担心支架塌陷或血栓形成导致基底动脉急性闭塞，我们未向动脉瘤内填充弹簧圈。术后，血管造影显示流入动脉瘤的血流显著减少，造影剂在静脉期仍有滞留。患者术后从全身麻醉中苏醒，未出现其他神经症状，三天后出院，并使用氯吡格雷和阿司匹林进行抗血小板治疗。六个月后他因复查入院，数字减影血管造影显示基底动脉完全闭塞，动脉瘤消失，尽管患者神经功能仍正常。
