CHU de Henri-Mondor, Créteil, AP-HP, service de neuroradiologie diagnostique et thérapeutique, 94000 Créteil, France.
CHU de Henri-Mondor, Créteil, AP-HP, service de neuroradiologie diagnostique et thérapeutique, 94000 Créteil, France.
J Neuroradiol. 2020 May;47(3):221-226. doi: 10.1016/j.neurad.2019.03.001. Epub 2019 Mar 20.
The neurological complications of Sickle Cell Disease (SCD) include cerebral infarction and haemorrhage with rarely subarachnoid haemorrhage due to cerebral aneurysms.
In our interventional department, working with SCD referral department, we reported our experience concerning management of adult's patients with cerebral aneurysms. We identified 26 adults with 48 intracranial aneurysms documented by imaging.
18 patients, with 26 cerebral aneurysms were treated by endovascular approach for their aneurysms. No patient was treated by surgical way in our institution. 50% of patients had multiple aneurysms. Locations of aneurysms treated were typical with 70% of cerebral anterior artery and 30% of posterior artery. Three patients suffered from subarachnoid haemorrhage. Two procedure-related complications occurred during the treatment: one thrombo-embolic event with good recovery after medical treatment and one aneurismal perforation leading to the death of patient. Hypercoagulability is a major specific risk in SCD and use of permanent device as stent of flow diverter should be discussed to prevent complications.
Endovascular management of these aneurysms seems to be a good alternative to treat these patients, with stability of occlusion at follow-up.
镰状细胞病（SCD）的神经系统并发症包括脑梗死和出血，由于脑动脉瘤很少引起蛛网膜下腔出血。
在我们的介入治疗部门，与 SCD 转诊部门合作，我们报告了我们对成人脑动脉瘤患者管理的经验。我们确定了 26 名成年患者，他们的 48 个颅内动脉瘤通过影像学检查得到证实。
18 名患者，26 个脑动脉瘤通过血管内方法进行治疗。我们机构没有患者接受手术治疗。50%的患者有多发性动脉瘤。治疗的动脉瘤位置典型，70%为大脑前动脉，30%为大脑后动脉。3 名患者发生蛛网膜下腔出血。在治疗过程中发生了 2 例与治疗相关的并发症：1 例血栓栓塞事件，经药物治疗后恢复良好，1 例动脉瘤穿孔导致患者死亡。高凝状态是 SCD 的一个主要特定风险，应讨论使用永久性装置（如支架）来防止并发症。
对于这些患者，血管内治疗似乎是一种很好的治疗选择，随访时闭塞稳定。
