Samaniego Edgar A, Abdo German, Hanel Ricardo A, Lima Andrey, Ortega-Gutierrez Santiago, Dabus Guilherme
Division of Interventional Neuroradiology/Endovascular Neurosurgery, Department of Neurology, Neurosurgery and Radiology, University of Iowa, Iowa City, USA Departamento de Neuroradiologia Intervencionista, Hospital Eugenio Espejo, Quito, Ecuador.
Departamento de Neuroradiologia Intervencionista, Hospital Eugenio Espejo, Quito, Ecuador.
J Neurointerv Surg. 2016 Oct;8(10):1030-3. doi: 10.1136/neurintsurg-2015-012070. Epub 2015 Nov 3.
To describe the treatment of posterior inferior cerebellar artery (PICA) aneurysms with the Low-profile Visualized Intraluminal Support Device (LVIS Jr) stent.
The databases of three institutions were retrospectively reviewed. Patients who underwent endovascular treatment of PICA aneurysms using a reconstructive technique where the LVIS Jr stent was totally or partially deployed into the PICA were included in the analysis. Clinical presentation, aneurysm and PICA sizes, procedural complications, and clinical and angiographic follow-up information was recorded and analyzed.
Seven patients who underwent endovascular treatment of PICA aneurysms with an LVIS Jr stent were identified. Four aneurysms were treated in the acute phase of subarachnoid hemorrhage (SAH). There were no symptomatic complications. One patient had spasm distal to the stent as a result of mechanical straightening of the vessel. One patient was treated in the acute phase of SAH and required a gycoprotein IIb/IIIa inhibitor after the stent was implanted. This patient needed to be re-treated to complete embolization. All patients had good clinical outcomes (Glasgow Outcome Scale 5). No in-stent stenosis or occlusion was seen on short-term angiographic follow-up and the aneurysms were occluded.
This small series suggests that the use of a reconstructive technique with the LVIS Jr stent for the treatment of PICA aneurysms is feasible, safe and effective in the short term.
描述使用低轮廓可视化腔内支撑装置（LVIS Jr）支架治疗小脑后下动脉（PICA）动脉瘤。
对三家机构的数据库进行回顾性分析。纳入采用重建技术对PICA动脉瘤进行血管内治疗且LVIS Jr支架全部或部分置入PICA的患者。记录并分析临床表现、动脉瘤及PICA大小、手术并发症以及临床和血管造影随访信息。
确定7例采用LVIS Jr支架对PICA动脉瘤进行血管内治疗的患者。4例动脉瘤在蛛网膜下腔出血（SAH）急性期接受治疗。未出现有症状的并发症。1例患者因血管机械性伸直出现支架远端痉挛。1例患者在SAH急性期接受治疗，植入支架后需要使用糖蛋白IIb/IIIa抑制剂。该患者需要再次治疗以完成栓塞。所有患者临床结局良好（格拉斯哥预后评分5分）。短期血管造影随访未见支架内狭窄或闭塞，动脉瘤闭塞。
这个小样本系列研究表明，采用LVIS Jr支架重建技术治疗PICA动脉瘤在短期内是可行、安全且有效的。
