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用于治疗儿童创伤性颅内动脉瘤的血管内栓塞装置

Pipeline embolization device for the treatment of a traumatic intracranial aneurysm in a child.

作者信息

Trivelato Felipe Padovani, Rezende Marco Túlio Salles, Fonseca Luiz Venâncio, Bonadio Lucas Eduardo, Ulhôa Alexandre Cordeiro, Abud Daniel Giansante

机构信息

Division of Interventional Neuroradiology, Hospital Felício Rocho, Belo Horizonte, Minas Gerais, Brazil.

Division of Interventional Neuroradiology, Hospital das Clínicas Faculdade de Medicina, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.

出版信息

Childs Nerv Syst. 2017 May;33(5):869-872. doi: 10.1007/s00381-016-3334-5. Epub 2017 Jan 7.

Abstract

INTRODUCTION

Traumatic intracranial aneurysms in children are rare and may occur as the result of closed or penetrating head trauma. Their natural history seems to be more aggressive. Most traumatic aneurysms have complex shape, tending to have a large neck or even a fusiform morphology.

CASE REPORT

We present a case of a traumatic carotid artery aneurysm in a 9-year-old girl that was successfully treated with pipeline embolization device.

DISCUSSION

Due to its dissecting nature, wall friability and lack of a substantial neck can make surgical clipping and selective coiling difficult and risky. Although endovascular parent artery occlusion is the best approach in the acute phase, in some situations it is not possible or very risky. In such scenario the use of flow diverter devices would be an alternative approach. Additionally, we discuss the potential advantages and risks of flow diverter deployment inside a developing vessel.

摘要

引言

儿童创伤性颅内动脉瘤较为罕见,可能由闭合性或穿透性头部创伤引起。其自然病史似乎更具侵袭性。大多数创伤性动脉瘤形状复杂,往往有较宽的颈部甚至呈梭形形态。

病例报告

我们报告一例9岁女孩的创伤性颈动脉动脉瘤,该病例通过管道栓塞装置成功治疗。

讨论

由于其夹层性质、血管壁脆弱以及缺乏明显的颈部,手术夹闭和选择性线圈栓塞可能困难且有风险。尽管血管内 parent 动脉闭塞在急性期是最佳方法,但在某些情况下无法实施或风险极大。在这种情况下,使用血流分流装置将是一种替代方法。此外,我们讨论了在发育中的血管内部署血流分流装置的潜在优势和风险。

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