Zanaty Mario, Jabbour Pascal M, Bou Sader Roula, Chalouhi Nohra, Tjoumakaris Stavropoula, Rosenwasser Robert H, Fernando Gonzalez L
Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, 901 Walnut Street, 3rd Floor, Philadelphia, PA 19107, USA.
Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, 901 Walnut Street, 3rd Floor, Philadelphia, PA 19107, USA.
J Clin Neurosci. 2015 Jan;22(1):105-10. doi: 10.1016/j.jocn.2014.05.033. Epub 2014 Sep 2.
Flow diversion has been successfully used to treat large and giant intracranial aneurysms that present with mass effect. We conducted a retrospective review, evaluating the modification of thrombi in this aneurysm type after treatment with the Pipeline Embolization Device (ev3 Endovascular, Plymouth, MN, USA) and the effects of these modifications on symptoms. Eight patients, seven of whom were female, harbored eight partially thrombosed large or giant aneurysms. Five of the eight aneurysms presented with symptomatic mass effect. At 1 year follow-up, complete occlusion occurred in 75% (6/8) of patients. On average, the longest thrombus diameter measured 22.31 mm before treatment and 14.05 mm 1 year afterwards. Seven of the eight thrombi regressed, as did their aneurysms. All six patients with shrunken thrombi had tremendous symptom improvement and became asymptomatic in the following year. The current findings seem to reflect the size variation of the intra-aneurysmal thrombus rather than the size of the aneurysm itself.
血流导向已成功用于治疗出现占位效应的大型和巨大型颅内动脉瘤。我们进行了一项回顾性研究，评估使用Pipeline栓塞装置（美国明尼苏达州普利茅斯市ev3血管内公司）治疗后此类动脉瘤内血栓的变化及其对症状的影响。8例患者（7例女性）患有8个部分血栓形成的大型或巨大型动脉瘤。8个动脉瘤中有5个出现有症状的占位效应。在1年随访时，75%（6/8）的患者实现完全闭塞。治疗前血栓最长直径平均为22.31mm，1年后为14.05mm。8个血栓中有7个缩小，其动脉瘤也缩小。血栓缩小的6例患者症状均有显著改善，并在次年无症状。目前的研究结果似乎反映了动脉瘤内血栓大小的变化，而非动脉瘤本身的大小。
