支架辅助弹簧圈栓塞术治疗后下小脑动脉动脉瘤并发动脉撕脱伤
Stent-assisted coiling of posterior inferior cerebellar artery aneurysm complicated by arterial avulsion.
作者信息
Cora E A, Finitsis S, Woulfe J, Essbaiheen F, AlQahtani H, Drake B, Lesiuk H, Iancu D
机构信息
1 The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
2 Aristotle University of Thessaloniki, Thessaloníki, Greece.
出版信息
Interv Neuroradiol. 2018 Dec;24(6):650-654. doi: 10.1177/1591019918793353. Epub 2018 Aug 19.
BACKGROUND
Rapid development of new devices and techniques in endovascular neurosurgery allows treatment of complex intracranial vascular lesions. These treatments, however, are not without risk. We report a case of unusual vascular laceration during stent-assisted coiling of a posterior inferior cerebellar artery (PICA) aneurysm.
CASE PRESENTATION
A 75-year-old female with a recurrent, previously coiled PICA aneurysm developed avulsion of the parent vessel followed by fatal bleeding while an attempt was made to place a microcatheter across the aneurysmal neck for stent-assisted coiling.
CONCLUSIONS
Pathological examination was performed to understand the mechanism of the rupture. The most likely mechanism was straightening of the significant vascular tortuosity, excessive tension on the vessel origin and avulsion upon advancement of the microcatheter over the microguidewire.
背景
血管内神经外科新设备和技术的快速发展使得复杂颅内血管病变的治疗成为可能。然而，这些治疗并非没有风险。我们报告一例在小脑后下动脉（PICA）动脉瘤支架辅助栓塞过程中发生罕见血管撕裂的病例。
病例介绍
一名75岁女性，患有复发性、先前已栓塞过的PICA动脉瘤，在试图将微导管穿过瘤颈进行支架辅助栓塞时，母血管发生撕裂，随后出现致命性出血。
结论
进行了病理检查以了解破裂机制。最可能的机制是显著的血管迂曲变直、血管起始部的过度张力以及微导管在微导丝上推进时的撕裂。
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