Borota Ljubisa, Mahmoud Ehab, Nyberg Christoffer, Lewén Anders, Enblad Per, Ronne-Engström Elisabeth
Department of Surgical Sciences, University Hospital, Uppsala, Sweden.
Department of Surgical Sciences, University Hospital, Uppsala, Sweden.
J Clin Neurosci. 2018 May;51:91-99. doi: 10.1016/j.jocn.2018.01.070. Epub 2018 Feb 23.
The aim of this study was to describe our experience in the treatment of various pathological conditions of the cranial and spinal blood vessels and hypervascularized lesions using dual lumen balloon catheters. Twenty-five patients were treated with endovascular techniques: two with vasospasm of cerebral blood vessels caused by subarachnoid hemorrhage, one with a hypervascularized metastasis in the vertebral body, two with spinal dural fistula, four with cerebral dural fistula, three with cerebral arteriovenous malformations, and 13 with aneurysms. The dual lumen balloon catheters were used for remodeling of the coil mesh, injection of various liquid embolic agents, particles and nimodipine, for the prevention of reflux and deployment of coils and stents. The diameter of catheterized blood vessels varied from 0.7 mm to 4 mm. Two complications occurred: perforation of an aneurysm in one case and gluing of the tip of balloon catheter by embolic material in another case. All other interventions were uneventful, and therapeutic goals were achieved in all cases except in the case with gluing of the tip of balloon catheter. The balloons effectively prevented reflux regardless of the type of the embolic material and diameter of blood vessel. The results of our study show that dual lumen balloon catheters allow complex interventions in the narrow cerebral and spinal blood vessels where the safe use of two single lumen catheters is either limited or impossible.
本研究的目的是描述我们使用双腔球囊导管治疗颅脑血管和脊髓血管的各种病理状况以及高血运性病变的经验。25例患者接受了血管内治疗技术:2例为蛛网膜下腔出血引起的脑血管痉挛,1例为椎体高血运性转移瘤,2例为脊髓硬脊膜瘘,4例为脑硬脑膜瘘,3例为脑动静脉畸形,13例为动脉瘤。双腔球囊导管用于重塑弹簧圈网、注射各种液体栓塞剂、颗粒和尼莫地平,以防止反流以及弹簧圈和支架的置入。导管插入的血管直径从0.7毫米到4毫米不等。发生了2例并发症:1例动脉瘤穿孔,另1例球囊导管尖端被栓塞材料黏附。所有其他干预均顺利,除球囊导管尖端被黏附的病例外,所有病例均实现了治疗目标。无论栓塞材料的类型和血管直径如何,球囊均能有效防止反流。我们的研究结果表明,双腔球囊导管可在狭窄的脑和脊髓血管中进行复杂干预,而在此类血管中安全使用两根单腔导管要么受到限制,要么无法实现。