Department of Neurosurgery, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Republic of Korea.
Acta Neurochir (Wien). 2013 Feb;155(2):223-9. doi: 10.1007/s00701-012-1528-5. Epub 2012 Nov 10.
Despite accumulated experience and improved understanding of the tools, endovascular treatment of intracranial aneurysms continues to have risks linked to the technique itself, and induces procedure-related complications. The purpose of this study was to report our series of stent salvage using the Enterprise stent for procedure-related complication during coil embolization in patients with ruptured intracranial aneurysms.
Parent artery thrombosis, parent artery dissection, and coil protrusion were considered to be the procedure-related complications. There were 18 consecutive cases (3 unruptured and 15 ruptured aneurysms) with procedure-related complications rescued by the Enterprise stent from December 2008 to December 2011. Follow-up angiography was performed in 14 of the 15 patients with ruptured aneurysms between 6 and 30 months (mean 14.6 months) after the procedure.
The procedure-related complications were parent artery dissection (n = 1), parent artery thrombosis (n = 4), and coil protrusion (n = 10). There was no complication related to delivering or deploying of the Enterprise stent. Initial radiographic results showed 8 cases of complete occlusion and 7 cases of neck remnant. There was no change in the angiographic results during the follow-up periods.
Facing with procedure-related complications during coil embolization of ruptured intracranial aneurysms, the closed-cell designed Enterprise stent might be a useful option for the salvage technique by restoring blood flow and minimizing thromboembolic events.
尽管积累了经验并加深了对工具的理解，血管内治疗颅内动脉瘤仍然存在与技术本身相关的风险，并会引发与手术相关的并发症。本研究旨在报告我们使用 Enterprise 支架治疗破裂颅内动脉瘤线圈栓塞术中与手术相关并发症的系列病例，这些并发症包括支架内血栓形成、载瘤动脉夹层和线圈突出。
载瘤动脉血栓形成、载瘤动脉夹层和线圈突出被认为是与手术相关的并发症。2008 年 12 月至 2011 年 12 月，我们使用 Enterprise 支架成功治疗了 18 例连续的与手术相关的并发症患者（3 例未破裂和 15 例破裂的动脉瘤）。15 例破裂动脉瘤患者中有 14 例在手术后 6 至 30 个月（平均 14.6 个月）进行了随访血管造影。
与手术相关的并发症包括载瘤动脉夹层（n=1）、载瘤动脉血栓形成（n=4）和线圈突出（n=10）。没有与 Enterprise 支架输送或展开相关的并发症。初始影像学结果显示 8 例完全闭塞，7 例瘤颈残留。在随访期间，血管造影结果没有变化。
在破裂颅内动脉瘤的线圈栓塞术中出现与手术相关的并发症时，采用密网孔设计的 Enterprise 支架可能是一种恢复血流和最小化血栓栓塞事件的有用的补救技术选择。
