Sirakov Stanimir, Panayotova Adriana, Sirakov Alexander, Penkov Marin, Minkin Krasimir, Hristov Hristo
1 Radiology Department, UH St Ivan Rilski, Bulgaria.
2 Neurosurgery Department, UH St Ivan Rilski, Bulgaria.
Neuroradiol J. 2019 Jun;32(3):193-199. doi: 10.1177/1971400919839375. Epub 2019 Apr 3.
The endovascular treatment of recurrent wide-necked bifurcation aneurysms at the basilar tip remains very challenging. Many different techniques and devices have emerged in recent years as potential options but results remain less than controversial. The pCANvas is a relatively new device wielding neck-bridging properties with a haemodynamically active membrane acting as blood flow disrupter.
We present the clinical case of a patient in whom multiple endovascular and microsurgical attempts failed to achieve the definitive treatment of a large and wide-necked basilar tip aneurysm. The patient underwent successful endovascular implantation of the novel pCANvas device across the recurrent aneurysm neck. The device limited the blood flow to the anerysmal lumen and thus promoted faster thrombosis. Third month follow-up confirmed complete obliteration of the aneurysm.
The application of the pCANvas device offers a potential treatment option in difficult and recurrent aneurysms. The endovascular flow disruption is a relatively new feature aiming to create conditions for intraluminal thrombosis and is certainly promising for the treatment of complex bifurcation aneurysms.
基底动脉尖部复发性宽颈分叉动脉瘤的血管内治疗仍然极具挑战性。近年来,许多不同的技术和器械作为潜在选择出现,但结果仍存在争议。pCANvas是一种相对较新的器械,具有颈部桥接特性,其血流动力学活性膜可作为血流干扰器。
我们报告一例患者的临床病例,该患者多次血管内和显微手术尝试均未能成功根治一个大型宽颈基底动脉尖部动脉瘤。该患者成功接受了新型pCANvas器械经复发性动脉瘤颈部的血管内植入。该器械限制了动脉瘤腔内的血流,从而促进了更快的血栓形成。三个月的随访证实动脉瘤完全闭塞。
pCANvas器械的应用为难治性和复发性动脉瘤提供了一种潜在的治疗选择。血管内血流干扰是一个相对较新的特性,旨在为腔内血栓形成创造条件,对于复杂分叉动脉瘤的治疗肯定很有前景。