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支架辅助弹簧圈栓塞术:治疗宽颈、夹层及梭形动脉瘤。

Stent Assisted Coil Embolization: the Treatment of Wide-necked, Dissecting, and Fusiform Aneurysms.

作者信息

Irie K, Negoro M, Hayakawa M, Eayashi J, Kanno T

机构信息

Department of Neurosurgery, Fujita Health University; Japan -

出版信息

Interv Neuroradiol. 2003 Sep 30;9(3):255-61. doi: 10.1177/159101990300900304. Epub 2004 Oct 22.

Abstract

Stent assisted coil embolization is a useful therapeutic modality for wide-necked and geometrically difficult aneurysms, as the stent provide a buttress that allows for coil deposition while preventing coil haerniation into the parent vessel lumen, and placement of an endovascular stent within the parent artery across the aneurysm neck may divert the blood from the aneurysm inflow tract and promote intra-aneurysm stasis and thrombosis.We report herein a 3 patients treated with endovascular stent-assisted coil embolization for symptomatic or enlarging wide-necked, dissecting, and fusiform aneurysms of the carotid and vertebrobasilar arteries. One patient had intracranial mass effect, the second had subarachnoid haemorrhage, and the third had angiographic evidence of enlarging aneurysm. The aneurysm was located in the petrous segment of internal carotid artery in one patient and in the intracranial vertebral artery in the other two patients. For all patients, we used balloon expandable stent (such as GFX, S-670) in this technique. Complete obliteration of the aneurysms could be achieved in all cases, with preservation of distal circulation.

摘要

支架辅助弹簧圈栓塞术是治疗宽颈和形态复杂动脉瘤的一种有效治疗方式,因为支架可提供支撑,便于弹簧圈的置入,同时防止弹簧圈疝入载瘤血管腔。在载瘤动脉内横跨瘤颈放置血管内支架可改变动脉瘤流入道的血流,促进瘤内血栓形成。在此,我们报告3例采用血管内支架辅助弹簧圈栓塞术治疗的有症状或进行性增大的宽颈、夹层及梭形颈内动脉和椎基底动脉动脉瘤患者。1例患者有颅内占位效应,第2例有蛛网膜下腔出血,第3例有动脉瘤增大的血管造影证据。1例患者的动脉瘤位于颈内动脉岩骨段,另外2例患者的动脉瘤位于颅内椎动脉。对所有患者,我们在该技术中使用了球囊扩张式支架(如GFX、S-670)。所有病例均实现了动脉瘤的完全闭塞,且保留了远端循环。

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本文引用的文献

1
Transluminal stent-assisted coil embolization of a vertebral confluence aneurysm: technique report.
Surg Neurol. 2001 May;55(5):291-6. doi: 10.1016/s0090-3019(01)00421-9.
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J Neurosurg. 2001 Mar;94(3):427-32. doi: 10.3171/jns.2001.94.3.0427.
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Stent-supported coil embolization: the treatment of fusiform and wide-neck aneurysms and pseudoaneurysms.
Neurosurgery. 2000 Jul;47(1):107-13; discussion 113-5. doi: 10.1097/00006123-200007000-00023.
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Clin Neurosurg. 1999;45:249-55.
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Stenting and secondary coiling of intracranial internal carotid artery aneurysm: technical case report.
Neurosurgery. 1998 Nov;43(5):1229-34. doi: 10.1097/00006123-199811000-00130.
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Stents for intracranial aneurysms: the beginning of a new endovascular era?
Neurosurgery. 1998 Aug;43(2):377-9. doi: 10.1097/00006123-199808000-00126.

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