Bhogal Pervinder, Aguilar Pérez Marta, Martinez Moreno Rosa, Miś Marcin, Miś Maciej, Henkes Hans
1 Neuroradiological Clinic, Neurocenter, Klinikum Stuttgart, Germany.
2 Department of Neurosurgery, Specialized Hospital, Poland.
Interv Neuroradiol. 2017 Apr;23(2):123-128. doi: 10.1177/1591019916680571. Epub 2016 Dec 5.
Objective The aim of this study was to report our initial experience of the use of the pCONus neck protection device in conjunction with the Solitaire AB stent to assist in the endovascular management of complex intracranial aneurysms with arteries arising from both the neck and the dome of the aneurysm. Methods Two patients with unruptured aneurysms underwent elective endovascular management of their aneurysms, one arising from the middle cerebral artery bifurcation and one from the anterior communicating artery. Both aneurysms had vessels arising from the neck and dome of the aneurysm. We present the strategy involved to protect all the arterial branches and coil occlude the aneurysm, the angiographic appearances and clinical status of the patients. Results Both cases involved the combined use of a pCONus and Solitaire stent. The parent vessel and efferent branches were all preserved with exclusion of the aneurysm from the circulation. There were no intraoperative complications. One patient developed mild transient symptoms 24 hours post procedure, which had resolved completely on discharge. Conclusion The use of the pCONus in conjunction with the Solitaire stent is a useful combination when dealing with complex wide-necked aneurysms with arteries derived from the fundus of the aneurysm.
目的 本研究的目的是报告我们使用pCONus颈部保护装置联合Solitaire AB支架辅助血管内治疗复杂颅内动脉瘤(动脉瘤颈部和瘤顶均有动脉发出)的初步经验。方法 两名未破裂动脉瘤患者接受了择期动脉瘤血管内治疗,一例动脉瘤起源于大脑中动脉分叉处,另一例起源于前交通动脉。两个动脉瘤的颈部和瘤顶均有血管发出。我们介绍了保护所有动脉分支并通过弹簧圈栓塞动脉瘤所涉及的策略、患者的血管造影表现和临床状况。结果 两例均联合使用了pCONus和Solitaire支架。保留了载瘤血管和传出分支,使动脉瘤与循环隔绝。术中无并发症。一名患者术后24小时出现轻度短暂症状,出院时已完全缓解。结论 当处理瘤顶有动脉发出的复杂宽颈动脉瘤时,pCONus与Solitaire支架联合使用是一种有效的组合。