Nakahara T, Kurisu K, Yano T, Sakoda K
Department of Neurosurgery, Hiroshima University School of Medicine; Mazda Hospital, Hiroshima, Japan -
Interv Neuroradiol. 1999 Jun 30;5(2):171-7. doi: 10.1177/159101999900500211. Epub 2001 May 15.
A 43-year-old man with dissecting vertebral artery aneurysm presented with subarachnoid haemorrhage. The vertebral angiography showed a fusiform dilatation at the right intracranial vertebral artery between the origin of posterior inferior cerebellar artery and the vertebral union. After failing conservative therapy, a balloon-expandable stent was placed at intracranial vertebral artery, in a manner such that the entire dissecting aneurysm was covered. On follow-up angiogram, we recognized regrowth of theresidual aneurysm and stent deformation. The parent artery was occluded completely with several Guglielmi detachable coils. Brainstem dysfunction or rebleeding of the aneurysm were not encountered. Recently stenting therapy was deployed for a patient with dissecting aneurysm of the extracranial carotid or vertebral artery who was not a candidate for surgical treatment. We discuss the feasibilities and limitations of stent therapy.
一名43岁患有椎动脉夹层动脉瘤的男性出现蛛网膜下腔出血。椎动脉血管造影显示右侧颅内椎动脉在小脑后下动脉起源与椎动脉汇合处之间呈梭形扩张。保守治疗失败后，在颅内椎动脉放置了一个球囊可扩张支架，将整个夹层动脉瘤覆盖。在随访血管造影中，我们发现残余动脉瘤再生长和支架变形。用多个 Guglielmi 可脱性弹簧圈将供血动脉完全闭塞。未出现脑干功能障碍或动脉瘤再出血。最近，对于一名不适合手术治疗的颅外颈动脉或椎动脉夹层动脉瘤患者采用了支架治疗。我们讨论了支架治疗的可行性和局限性。
