1例破裂性椎基底动脉交界区动脉瘤合并锁骨下动脉盗血现象
A Case of Ruptured Vertebrobasilar Junction Aneurysm Associated with Subclavian Steal Phenomenon.
作者信息
Okuhara Tetsuya, Hashimoto Koji, Kanemaru Kazuya, Yoshioka Hideyuki, Yagi Takashi, Obata Jun-Ei, Kugiyama Kiyotaka, Kinouchi Hiroyuki
机构信息
Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan.
Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan.
出版信息
J Stroke Cerebrovasc Dis. 2017 Aug;26(8):e160-e164. doi: 10.1016/j.jstrokecerebrovasdis.2017.05.001. Epub 2017 Jun 1.
A 77-year-old woman with arteriovenous shunt for hemodialysis in the left forearm suffered from subarachnoid hemorrhage due to the rupture of a saccular aneurysm located on the left lateral wall of vertebrobasilar junction. Her left subclavian artery was severely stenosed and subclavian steal phenomenon was demonstrated on the digital subtraction angiography. Embolization of the parent artery including the aneurysm using detachable coils resulted in the successful obliteration of the aneurysm through the revascularized left subclavian artery. This is the first case in which the vertebrobasilar junction aneurysm would be caused by the hemodynamic stress due to the subclavian steal phenomenon combined with the shunt for hemodialysis in the left forearm.
一名77岁女性，左前臂有用于血液透析的动静脉分流，因位于椎基底动脉交界处左侧壁的囊状动脉瘤破裂而发生蛛网膜下腔出血。她的左锁骨下动脉严重狭窄，数字减影血管造影显示有锁骨下窃血现象。使用可脱卸弹簧圈对包括动脉瘤在内的供血动脉进行栓塞，通过再通的左锁骨下动脉成功闭塞了动脉瘤。这是首例因锁骨下窃血现象合并左前臂血液透析分流导致的血流动力学压力引起椎基底动脉交界处动脉瘤的病例。
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