Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA.
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
World Neurosurg. 2020 Feb;134:580-583. doi: 10.1016/j.wneu.2019.06.161. Epub 2019 Jun 26.
Dual antiplatelet therapy has been adopted as the standard of care for intracranial stenting, including flow diversion of cerebral aneurysms, to reduce the risk of acute and delayed ischemic complications.
This is a report of 2 cases in which patients who underwent flow diversion of unruptured internal carotid artery aneurysms were treated with aspirin monotherapy. Neither patient tolerated dual antiplatelet therapy, one because of nosebleeds due to hereditary hemorrhagic telangiectasia and one because of an unnamed bleeding disorder. The lesions-a previously coiled, recanalizing dorsal internal carotid artery aneurysm and a small superior hypophyseal aneurysm-were each treated with a single Pipeline Flex embolization device and were completely occluded with normal-appearing parent vessel on 12-month follow-up digital subtraction angiography.
This is the first report of patients electively treated with flow diversion using Pipeline Flex embolization device on aspirin monotherapy in the literature.
颅内支架置入术（包括脑动脉瘤血流导向装置）采用双联抗血小板疗法作为标准治疗方案，以降低急性和迟发性缺血性并发症的风险。
本文报告了 2 例未破裂颈内动脉动脉瘤血流导向装置置入术后采用阿司匹林单药治疗的患者。这 2 例患者均不能耐受双联抗血小板治疗，1 例因遗传性出血性毛细血管扩张症导致鼻出血，另 1 例因不明原因出血性疾病。病变-先前弹簧圈治疗的再通背侧颈内动脉动脉瘤和小的垂体上动脉瘤-分别使用单个 Pipeline Flex 栓塞装置治疗，12 个月时的数字减影血管造影显示载瘤动脉正常，完全闭塞。
这是文献中首次报告的使用 Pipeline Flex 栓塞装置在阿司匹林单药治疗下选择性进行血流导向装置治疗的患者。
