Chen Ching-Jen, Patibandla M Rao, Park Min S, Kalani M Yashar
Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, USA.
J Neurosci Rural Pract. 2019 Jan-Mar;10(1):142-144. doi: 10.4103/jnrp.jnrp_273_18.
Despite the widespread use of the pipeline embolization device (PED), no complete aneurysm regrowth after its placement has been reported in the literature. We report the first case of aneurysm regrowth after the initial follow-up angiography demonstrating near-complete occlusion of the aneurysm and remodeling of the vessel with on-label PED use for a large 20 mm × 24 mm × 22 mm (width × depth × height) cavernous segment internal carotid artery (ICA) aneurysm. The patient was treated with two overlapping PED (4.5 mm × 20 mm and 5 mm × 20 mm). Follow-up angiogram at 4 months after treatment demonstrated remodeling of the ICA with a small residual component measuring approximately 7 mm × 8 mm × 7 mm. However, at 10 months after treatment, there was a complete regrowth of the aneurysm with interval growth, now measuring 25 mm × 28 mm × 18 mm. Despite the high aneurysm occlusion rates reported with the PED, persistent aneurysm filling and aneurysm regrowth, although rare, should not be overlooked.
尽管管道栓塞装置（PED）已被广泛使用，但文献中尚未报道其置入后动脉瘤完全再生长的情况。我们报告了首例动脉瘤再生长病例，最初的随访血管造影显示动脉瘤近乎完全闭塞且血管重塑，该大型海绵窦段颈内动脉（ICA）动脉瘤尺寸为20 mm×24 mm×22 mm（宽×深×高），使用的是符合标签规定的PED。该患者接受了两个重叠的PED治疗（4.5 mm×20 mm和5 mm×20 mm）。治疗后4个月的随访血管造影显示ICA重塑，有一个小的残余部分，尺寸约为7 mm×8 mm×7 mm。然而，治疗后10个月，动脉瘤出现间隔生长并完全再生长，现在尺寸为25 mm×28 mm×18 mm。尽管报道称PED的动脉瘤闭塞率很高，但持续性动脉瘤充盈和动脉瘤再生长，尽管罕见，也不应被忽视。
