Bhogal Pervinder, Chudyk Jorge, Bleise Carlos, Lylyk Ivan, Henkes Hans, Lylyk Pedro
1 Clinic for Neuroradiology, Klinikum Stuttgart, Stuttgart, Germany.
2 Neuroradiological clinic, Clinica Sagrada Familia, ENERI, Buenos Aires, Argentina.
Interv Neuroradiol. 2018 Oct;24(5):489-498. doi: 10.1177/1591019918774877. Epub 2018 May 28.
Objective The objective of this study was to report our experience on the use of flow diverting stents placed within the posterior inferior cerebellar artery (PICA) as a treatment option for aneurysms of the PICA. Methods Three patients with aneurysms of the PICA, both ruptured and unruptured, underwent treatment of their aneurysms with placement of a single flow diverter in the PICA across the neck of the aneurysm. Adjunctive techniques such as coiling were not used. We present the angiographic and clinical follow-up data. Results The procedure was a technical success in all cases and there were no intraoperative complications. Follow-up data were available for two patients and this showed complete occlusion of the aneurysm with the PICA remaining patent. There was no evidence, either clinical or radiological, of medullary or pontine infarction. One patient died during the follow-up period from an unrelated medical illness (community acquired pneumonia). Conclusion Flow diverters can be successfully placed within the PICA to treat both ruptured and unruptured aneurysms, and they represent an alternative treatment option to endovascular coiling or microscopic neurosurgery.
目的 本研究的目的是报告我们使用置于小脑后下动脉（PICA）内的血流导向支架作为PICA动脉瘤治疗选择的经验。方法 3例PICA动脉瘤患者，包括破裂和未破裂的，通过在PICA内横跨动脉瘤颈部放置单个血流导向装置对其动脉瘤进行治疗。未使用如弹簧圈栓塞等辅助技术。我们展示了血管造影和临床随访数据。结果 该手术在所有病例中技术成功，且无术中并发症。两名患者有随访数据，显示动脉瘤完全闭塞，PICA保持通畅。没有髓质或脑桥梗死的临床或影像学证据。一名患者在随访期间死于无关的内科疾病（社区获得性肺炎）。结论 血流导向装置可成功置于PICA内以治疗破裂和未破裂的动脉瘤，它们代表了血管内弹簧圈栓塞或显微神经外科手术之外的另一种治疗选择。
