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封堵WEB并通过置入微导管进行盘绕:WEB辅助盘绕术,一种在治疗宽颈大型颅内动脉瘤时避免使用支架的有用技术。

Corking the WEB and coiling through a jailed microcatheter: WEB assisted coiling, a useful technique avoiding the use of stents in treating wide-necked large intracranial aneurysms.

作者信息

Leyon Joe Joseph, Chavda Swarupsinh, Lamin Saleh

机构信息

University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

出版信息

BMJ Case Rep. 2015 May 2;2015:bcr2015011649. doi: 10.1136/bcr-2015-011649.

Abstract

The WEB is an endovascular flow-disrupting device used in treating wide-necked intracranial aneurysms. Although the device is available in varying sizes, large aneurysms pose a challenge with the need for custom-made devices. We describe the use of coils as an adjunct to the WEB device in successfully treating large aneurysms in two patients, one with an acutely ruptured aneurysm. This novel technique of jailing a microcatheter, deploying the WEB and then coiling the aneurysm saves the need for intracranial stenting, thereby avoiding the need for antiplatelet therapy, which is of benefit in the setting of acute aneurysm rupture.

摘要

WEB是一种用于治疗宽颈颅内动脉瘤的血管内血流干扰装置。尽管该装置有多种尺寸可供选择,但大型动脉瘤需要定制装置,这带来了挑战。我们描述了在两名患者中使用弹簧圈作为WEB装置的辅助手段成功治疗大型动脉瘤的情况,其中一名患者患有急性破裂的动脉瘤。这种先将微导管置入、部署WEB然后对动脉瘤进行弹簧圈栓塞的新技术无需进行颅内支架置入,从而避免了抗血小板治疗的需要,这在急性动脉瘤破裂的情况下是有益的。

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