Cirillo L, Leonardi M, Dall'olio M, Princiotta C, Stafa A, Simonetti L, Toni F, Agati R
Neuroradiology Department, IRCCS of Neurological Sciences, Bellaria Hospital, University of Bologna, Italy.
Interv Neuroradiol. 2012 Dec;18(4):413-25. doi: 10.1177/159101991201800407. Epub 2012 Dec 3.
Flow-diverting stents (Silk and PED) have radically changed the approach to intracranial aneurysm treatment from the use of endosaccular materials to use of an extraaneurysmal endoluminal device. However, much debate surrounds the most appropriate indications for the use of FD stents and the problems raised by several possible complications.We analysed our technical difficulties and the early (less than ten days after treatment) and late complications encountered in 30 aneurysms treated comprising 13 giant lesions, 12 large, five with maximum diameters <10 mm and one blister-like aneurysm. In our experience the primary indications for the use of FD stents can be the symptomatic intracavernous giant aneurysms. Although the extracavernous carotid siphon aneurysms have major risk of bleeding, FD stents are indicated clearly explaining the risks to the patient in case of severe mass effect. There is a very complex assessment for aneurysms of the vertebrobasilar circulation.
血流导向支架（Silk和PED）已从使用瘤内材料彻底改变了颅内动脉瘤的治疗方法，转而使用动脉瘤腔内装置。然而，关于血流导向支架使用的最合适适应症以及几种可能并发症引发的问题存在诸多争议。我们分析了在治疗的30个动脉瘤中遇到的技术难题以及早期（治疗后不到十天）和晚期并发症，其中包括13个巨大病变、12个大型病变、5个最大直径<10mm的病变和1个水泡样动脉瘤。根据我们的经验，血流导向支架使用的主要适应症可以是有症状的海绵窦内巨大动脉瘤。尽管海绵窦外颈内动脉虹吸部动脉瘤有大出血风险，但在存在严重占位效应的情况下，向患者清楚解释风险后仍可使用血流导向支架。对于椎基底循环动脉瘤，评估非常复杂。
