Sirakov Stanimir S, Sirakov Alexander, Hristov Hristo, Raychev Radoslav
Radiology department, University Hospital St Ivan Rilski, Sofia, Bulgaria.
Neurosurgery Department, University Hospital St Ivan Rilski, Sofia, Bulgaria.
BMJ Case Rep. 2018 May 18;2018:bcr-2017-222703. doi: 10.1136/bcr-2017-222703.
In this report, we present a novel technique of successful coil embolisation using temporary deployment of two Comaneci devices placed in Y configuration across a wide-neck ruptured basilar tip aneurysm. The placement of two devices across the wide aneurysm neck allowed optimal coverage for safe coil delivery, while maintaining parent vessel patency. This case highlights the unique and safe applicability of two crossed Comaneci devices in a ruptured aneurysm with unfavourable anatomy, ultimately resulting in complete aneurysm obliteration. To our knowledge, this is the first reported case of double Comaneci usage in a wide-neck ruptured aneurysm. This technique can be potentially applied in challenging wide-neck bifurcation aneurysms, particularly when double antiplatelet therapy is of concern.
在本报告中，我们介绍了一种新颖的技术，即通过临时部署两个以Y形配置横跨宽颈破裂基底动脉尖动脉瘤放置的科马内奇装置成功进行弹簧圈栓塞。在宽动脉瘤颈上放置两个装置可实现最佳覆盖，以安全地输送弹簧圈，同时保持载瘤血管通畅。该病例突出了两个交叉的科马内奇装置在解剖结构不利的破裂动脉瘤中的独特且安全的适用性，最终实现了动脉瘤的完全闭塞。据我们所知，这是首次报道在宽颈破裂动脉瘤中使用双科马内奇装置的病例。该技术可能适用于具有挑战性的宽颈分叉动脉瘤，尤其是在担心双重抗血小板治疗的情况下。
