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支架辅助夹闭术治疗复杂颈内动脉颅内动脉瘤

Stent-Assisted Clip Placement for Complex Internal Carotid Artery Intracranial Aneurysms.

作者信息

Qureshi Adnan I, Chughtai Morad, Khan Asif A, Suri M Fareed K, Sherr Gregory T

机构信息

Zeenat Qureshi Stroke Institute, St. Cloud, MN, USA.

Zeenat Qureshi Stroke Institute, St. Cloud, MN, USA; Department of Neurosurgery, CentraCare Health, St. Cloud, MN, USA.

出版信息

J Vasc Interv Neurol. 2016 Jan;8(5):23-9.

PMID:26958150
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4762408/
Abstract

BACKGROUND

We report two procedures using a stent-assisted microsurgical clip placement to treat complex intracranial aneurysms originating from supraclinoid segment of the internal carotid artery.

CASE DESCRIPTIONS

In both procedures, primary clip placement was considered technically difficult due to either complex morphology or inferior protrusion of aneurysm fundus within the interclinoid space. A nitinol self-expanding stent was placed across the neck of the aneurysm either preoperatively or intraoperatively. Obliteration of aneurysm and patency of the artery was confirmed by angiography after clip placement.

CONCLUSION

Description of an integrated open microsurgical and endovascular approach and review of literature pertaining to considerations for treatment approach are discussed.

摘要

背景

我们报告了两种使用支架辅助显微外科夹闭术治疗起源于颈内动脉床突上段的复杂颅内动脉瘤的手术方法。

病例描述

在这两种手术中,由于动脉瘤形态复杂或瘤底在床突间间隙内突出不佳,初次夹闭术在技术上被认为具有难度。术前或术中在动脉瘤颈部放置镍钛诺自膨式支架。夹闭术后通过血管造影确认动脉瘤闭塞和动脉通畅。

结论

讨论了一种综合的开放显微外科和血管内治疗方法的描述以及与治疗方法考量相关的文献综述。

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本文引用的文献

1
Surgical microanatomy of the anterior clinoid process for paraclinoid aneurysm surgery and efficient modification of extradural anterior clinoidectomy.用于鞍旁动脉瘤手术的前床突手术显微解剖及硬膜外前床突切除术的有效改良
World Neurosurg. 2015 Apr;83(4):635-43. doi: 10.1016/j.wneu.2014.12.014. Epub 2014 Dec 17.
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Assessing Blood Flow in an Intracranial Stent: A Feasibility Study of MR Angiography Using a Silent Scan after Stent-Assisted Coil Embolization for Anterior Circulation Aneurysms.评估颅内支架内的血流:一项关于支架辅助弹簧圈栓塞治疗前循环动脉瘤后使用静音扫描进行磁共振血管造影的可行性研究。
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Hemodynamic effects of stent struts versus straightening of vessels in stent-assisted coil embolization for sidewall cerebral aneurysms.在支架辅助弹簧圈栓塞治疗侧壁脑动脉瘤中,支架支柱与血管伸直的血流动力学效应。
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Multiple overlapping stent-assisted coiling of complex aneurysms: a single-center experience.复杂动脉瘤的多次重叠支架辅助弹簧圈栓塞术:单中心经验
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Stent-assisted coil embolization of ruptured wide-necked aneurysms in the acute period: incidence of and risk factors for periprocedural complications.支架辅助弹簧圈栓塞治疗急性期宽颈破裂动脉瘤:围手术期并发症的发生率及危险因素。
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Blood blister-like aneurysms: single center experience and systematic literature review.血疱样动脉瘤:单中心经验和系统文献回顾。
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Stent-assisted coiling in endovascular treatment of 500 consecutive cerebral aneurysms with long-term follow-up.支架辅助弹簧圈栓塞治疗 500 例连续脑动脉瘤的长期随访结果。
AJNR Am J Neuroradiol. 2013 Nov-Dec;34(11):2157-62. doi: 10.3174/ajnr.A3574. Epub 2013 Jul 25.
8
Angular remodeling in single stent-assisted coiling displaces and attenuates the flow impingement zone at the neck of intracranial bifurcation aneurysms.支架辅助弹簧圈栓塞术治疗颅内分叉部动脉瘤时,动脉瘤瘤颈处的流固耦合效应导致的血管重构会改变和削弱流冲击区。
Neurosurgery. 2013 May;72(5):739-48; discussion 748. doi: 10.1227/NEU.0b013e318286fab3.
9
Ruptured aneurysm with delayed distal coil migration requiring surgical treatment. Case report.伴有延迟性远端弹簧圈移位的破裂动脉瘤,需手术治疗。病例报告。
Neurol Med Chir (Tokyo). 2012;52(6):439-42. doi: 10.2176/nmc.52.439.
10
Assessment of platelet inhibition by point-of-care testing in neuroendovascular procedures.神经血管介入手术中即时检验的血小板抑制作用评估。
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