Department of Radiology, Careggi University Hospital, Florence, Italy.
J Neurointerv Surg. 2012 May;4(3):e4. doi: 10.1136/jnis.2010.004572. Epub 2011 Jun 8.
Neurosurgical and endovascular treatment of fragile and recurrent aneurysms of the non-branching portion of the internal carotid artery, known as blister-like aneurysms, is challenging. The aim of this paper is to describe two cases of ruptured blister-like aneurysms of the internal carotid artery and of the vertebral artery at the origin of the postero-inferior cerebellar artery, which were both treated with flow diverter (FD) stents.
Two patients with a sub-arachnoid hemorrhage secondary to the rupture of a blister-like aneurysm were treated with a Pipeline (ev3, Irvine, California, USA) stent. Digital subtraction angiography and clinical follow-up were carried out.
Both patients treated with FD stents had an excellent clinical (modified Rankin Scale, mRS 0) and angiographic outcome. In both cases the aneurysms were completely excluded after 6 months.
Although the use of this endovascular approach is still debated because of poor experience and pharmacological limitations, FD stents may represent a valid alternative approach for treatment of this aneurysm subtype.
对于非分支颈内动脉（称为“疱状”动脉瘤）的脆弱且易复发的动脉瘤，神经外科和血管内治疗极具挑战性。本文旨在描述两例破裂的颈内动脉和后下小脑后动脉起源处的椎动脉“疱状”动脉瘤病例，均采用了血流导向装置（FD）支架进行治疗。
对两名蛛网膜下腔出血继发于“疱状”动脉瘤破裂的患者采用 Pipeline（ev3，加利福尼亚州欧文，美国）支架进行治疗。对数字减影血管造影和临床随访结果进行分析。
接受 FD 支架治疗的两名患者均取得了极好的临床（改良 Rankin 量表，mRS 0）和血管造影结果。在这两种情况下，6 个月后动脉瘤完全被排除。
尽管由于经验不足和药物治疗的限制，这种血管内治疗方法的应用仍存在争议，但 FD 支架可能是治疗这种动脉瘤亚型的有效替代方法。
