Regional Neurosciences Centre, Neuroradiology Department, Newcastle General Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Tyne and Wear, United Kingdom.
Neurosurgery. 2010 Aug;67(2):E516-7. doi: 10.1227/01.NEU.0000372094.75062.D4.
With the development of support devices such as stents, an increasing number of aneurysms are meeting the criteria for endovascular treatment. A range of intracranial stents currently are available with an array of characteristics. It is essential to understand the properties of these stents to determine their role and implications in endovascular treatment of cerebral aneurysms.
A 45-year-old man presented to our institution with subarachnoid hemorrhage secondary to a small distal basilar trunk aneurysm.
An Enterprise stent (4.5 x 14 mm) was deployed in the parent vessel across the neck of the aneurysm. Repeat angiography 2 days later demonstrated significant proximal stent migration. A second, longer overlapping Enterprise stent (4.5 x 22 mm) was deployed from the left P1 segment into the basilar artery. Complete occlusion of the basilar trunk aneurysm was noted on subsequent angiography.
This is an unequivocal case of early spontaneous migration of a self-expanding intracranial stent. We suggest caution when there is significant discrepancy in luminal diameter and suboptimal wall apposition. Early imaging following stent deployment may be indicated in these cases.
随着支架等支持设备的发展，越来越多的动脉瘤符合血管内治疗的标准。目前有多种颅内支架，具有多种特性。了解这些支架的特性对于确定它们在颅内动脉瘤血管内治疗中的作用和意义至关重要。
一名 45 岁男性因小型远端基底干动脉瘤引起的蛛网膜下腔出血就诊于我院。
在载瘤动脉中穿过动脉瘤颈部植入 Enterprise 支架（4.5 x 14mm）。两天后重复血管造影显示近端支架明显迁移。从左侧 P1 段到基底动脉再植入一个更长的重叠 Enterprise 支架（4.5 x 22mm）。随后的血管造影显示基底干动脉瘤完全闭塞。
这是一个明确的自膨式颅内支架早期自发性迁移的病例。当管腔直径差异较大且贴壁不理想时，我们建议谨慎处理。在这些情况下，支架植入后早期进行影像学检查可能是必要的。
