大脑中动脉巨大未破裂动脉瘤的支架置入与手术联合治疗。
The combined treatment of stenting and surgery in a giant unruptured aneurysm of the middle cerebral artery.
作者信息
Skrap Miran, Petralia Benedetto, Toniato Giovanni
机构信息
Department of Neurosurgery, Udine University-Hospital P. le S. Maria della Misericordia 15, 33100, Udine, Italy.
Department of Neuroradiology, Udine University-Hospital P. le S. Maria della Misericordia 15, 33100, Udine, Italy.
出版信息
Surg Neurol Int. 2015 Apr 24;6:67. doi: 10.4103/2152-7806.155802. eCollection 2015.
BACKGROUND
This case study reports on a combined therapy of stenting and surgery for a giant unruptured middle cerebral artery (MCA) aneurysm with the aim of preserving the patency of the vessel during surgery.
CASE DESCRIPTION
A 51-year-old male presented with a sudden onset of moderate left hemiparesis and dysarthria. Neuro-radiological evaluations showed a giant right unruptured MCA aneurysm without subarachnoid hemorrhage (SAH). The cerebral angiography confirmed the presence of such an aneurysm producing compression of both M2 branches with consequent slowing of the blood flow. Two weeks later, the patient underwent the positioning of an Enterprise stent and inside this, a flow diverter Silk stent. They were placed across the aneurysm and in one of the two M2 branches with the aim of protecting them during surgical manipulation. The patient went immediately to surgery, where the aneurysm was resected and both M2 branches decompressed.
CONCLUSION
The combined placement of the stents allowed safe and successful surgical dissection of the M2 branches and clipping of the aneurysm without interrupting the blood flow.
背景
本病例研究报告了一种针对巨大未破裂大脑中动脉（MCA）动脉瘤的支架置入与手术联合治疗方法，旨在手术过程中保持血管通畅。
病例描述
一名51岁男性突发中度左侧偏瘫和构音障碍。神经放射学评估显示右侧有一个巨大的未破裂MCA动脉瘤，无蛛网膜下腔出血（SAH）。脑血管造影证实存在这样一个动脉瘤，它压迫了两个M2分支，导致血流减慢。两周后，患者接受了Enterprise支架置入，在其内部又置入了一个血流导向Silk支架。它们被放置在动脉瘤及两个M2分支之一上，目的是在手术操作期间保护它们。患者随即接受手术，术中切除了动脉瘤并解除了两个M2分支的压迫。
结论
联合置入支架使得在不中断血流的情况下安全、成功地对M2分支进行手术解剖并夹闭动脉瘤成为可能。
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