Martínez-Galdámez M, Saura P, Saura J, Martínez A, De Campos J M, Pérez A
Interventional Neuroradiology Unit, Radiology Department, Fundación Jiménez Díaz-CAPIO, Madrid, Spain.
Interv Neuroradiol. 2012 Jun;18(2):158-63. doi: 10.1177/159101991201800206. Epub 2012 Jun 4.
Wide-neck intracranial aneurysms remain a challenge to endovascular treatment. We describe our experience in repairing wide-neck aneurysms of the anterior circulation located at arterial branch points using coil embolization assisted by Y-stenting using two Solitaire(®) stents.Six wide-neck intracranial aneurysms located on the middle cerebral artery bifurcation( 3), pericallosal artery( 1), and anterior communicating artery( 2) were repaired by Y-stent-assisted coil embolization using two Solitaire(®) stents. Four cases were incidental findings of aneurysm and two cases were previously treated ruptured aneurysms that had undergone recanalization. All the cases were successfully treated without complications. Follow-up by digital subtraction angiography and magnetic resonance angiography at six months showed the stents to be patent with no recanalization of the aneurysm sacs. Repairing wide-neck aneurysms of the anterior circulation by Y-stent-assisted coil embolization using two Solitaire(®) stents is a simple and safe method of treating complex aneurysms. While the results are promising, larger series with longer term follow-ups are needed to corroborate that this treatment method is superior to other techniques.
宽颈颅内动脉瘤的血管内治疗仍然是一项挑战。我们描述了我们使用两枚Solitaire(®)支架通过Y形支架辅助弹簧圈栓塞术修复位于动脉分支点的前循环宽颈动脉瘤的经验。使用两枚Solitaire(®)支架通过Y形支架辅助弹簧圈栓塞术修复了6例位于大脑中动脉分叉处(3例)、胼周动脉(1例)和前交通动脉(2例)的宽颈颅内动脉瘤。4例为偶然发现的动脉瘤,2例为先前治疗过的破裂动脉瘤,已发生再通。所有病例均成功治疗,无并发症。6个月时通过数字减影血管造影和磁共振血管造影进行随访,结果显示支架通畅,动脉瘤囊未再通。使用两枚Solitaire(®)支架通过Y形支架辅助弹簧圈栓塞术修复前循环宽颈动脉瘤是一种治疗复杂动脉瘤的简单且安全的方法。虽然结果令人鼓舞,但需要更大规模的系列研究和更长时间的随访来证实这种治疗方法优于其他技术。