Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
AJNR Am J Neuroradiol. 2013 Jan;34(1):E1-4. doi: 10.3174/ajnr.A2613. Epub 2011 Aug 18.
The approach for treatment of large and fusiform intracranial aneurysms has evolved from stent-assisted coiling to treatment with flow-diverting stents. The treatment results for these stents are promising; however, early postprocedural aneurysm rupture has been described. The exact cause of rupture is unknown but might be related to intra-aneurysmal flow and pressure changes. We measured intra-aneurysmal pressure before, during, and after placement of a flow-diverting stent by using a dual-sensor guidewire. The pressure inside the aneurysm momentarily decreased during placement but was restored to baseline values within minutes. The flow-diverting stent does not seem to protect the aneurysm from the stress induced by pressure or pressure changes within the lumen.
治疗大型梭形颅内动脉瘤的方法已经从支架辅助弹簧圈治疗发展为使用血流导向支架治疗。这些支架的治疗效果很有前景,但也有术后早期动脉瘤破裂的报道。确切的破裂原因尚不清楚,但可能与瘤内血流和压力变化有关。我们使用双传感器导丝在放置血流导向支架前后测量了瘤内压力。支架放置过程中,瘤内压力短暂下降,但在数分钟内恢复到基线水平。血流导向支架似乎并不能防止动脉瘤因管腔内的压力或压力变化而受到的影响。