Kamide Tomoya, Misaki Kouichi, Nambu Iku, Mohri Masanao, Uchiyama Naoyuki, Nakada Mitsutoshi
Department of Neurosurgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
Acta Neurochir (Wien). 2017 Mar;159(3):593-598. doi: 10.1007/s00701-017-3083-6. Epub 2017 Jan 21.
Delayed coil migration after endovascular treatment with detachable coils, particularly several months after treatment, is extremely rare. In this report, the authors describe a 77-year-old female in whom delayed coil migration to the anterior cerebral artery and posterior communicating artery (PCoA) developed 3 months after an uncomplicated aneurysm embolization. The patient was successfully retreated with a closed-cell stent. Computational fluid dynamics (CFD) revealed high wall shear stress (WSS) and multiple vortices in the residual cavity of the initially treated aneurysm. CFD could be useful to detect and predict this complication, and a stent-assisted technique could be an important treatment option.
使用可脱卸弹簧圈进行血管内治疗后出现弹簧圈延迟移位，尤其是在治疗数月后，极为罕见。在本报告中，作者描述了一名77岁女性，在未发生并发症的动脉瘤栓塞术后3个月，出现弹簧圈延迟移位至大脑前动脉和后交通动脉（PCoA）。该患者通过使用闭孔支架成功进行了再次治疗。计算流体动力学（CFD）显示，在最初治疗的动脉瘤残余腔内存在高壁面切应力（WSS）和多个涡流。CFD有助于检测和预测这种并发症，而支架辅助技术可能是一种重要的治疗选择。
