Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA.
J Neurointerv Surg. 2013 Nov;5 Suppl 3:iii79-iii82. doi: 10.1136/neurintsurg-2012-010553. Epub 2012 Nov 20.
The 'balloon-then-stent' method involves stent placement after completion of a balloon-assisted embolization. The drawback to this technique is that the coil mass achieved during balloon remodeling must be crossed prior to stent deployment. This additional maneuver introduces the potential risk of coil disruption. We describe the first report of a novel technique employing the 'balloon-then-stent' method.
A 51-year-old patient with an unruptured right middle cerebral artery bifurcation aneurysm was treated with balloon remodeling employing a 4 × 10 mm Scepter C balloon catheter. Following coil embolization, a low-profile visualized intraluminal stent (LVIS) Jr 2.5 mm × 16 mm was delivered via the coaxial balloon catheter and deployed across the aneurysm neck.
Follow-up angiograms demonstrated that the coil mass was well-seated within the aneurysm sac and the parent vessel was widely patent with satisfactory vessel wall apposition by the stent.
We describe a technique for balloon remodeling followed by stenting for aneurysm coil embolization that incorporates the use of a coaxial dual-lumen balloon catheter system through which a novel self-expanding stent can be deployed. In the case described, we found this technique to be safe and feasible, reducing both the number of steps involved in this technique and the opportunities for mechanical coil-related complications.
“球囊后支架”方法涉及在球囊辅助栓塞完成后放置支架。该技术的缺点是,在部署支架之前,必须穿过球囊重塑过程中获得的线圈质量。这一额外的操作增加了线圈破裂的潜在风险。我们首次报道了一种采用“球囊后支架”方法的新技术。
一名 51 岁的患者患有未破裂的右侧大脑中动脉分叉部动脉瘤,采用 4×10mm 的 Scepter C 球囊导管进行球囊重塑。在进行线圈栓塞后,通过同轴球囊导管输送低剖面可视腔内支架(LVIS Jr 2.5mm×16mm),并穿过动脉瘤颈部进行部署。
随访血管造影显示,线圈质量很好地位于动脉瘤囊中,母血管通畅,支架与血管壁紧密贴合。
我们描述了一种用于动脉瘤线圈栓塞的球囊重塑后支架置入的技术,该技术采用同轴双腔球囊导管系统,可通过该系统部署一种新型自扩张支架。在描述的病例中,我们发现该技术是安全可行的,减少了该技术涉及的步骤数量,降低了与线圈相关的机械并发症的发生机会。