Kim Seung Soo, Park Hyun, Lee Kwang Ho, Jung Seunguk, Yoon Chang Hyo, Kim Sung Kwon, Ryu Kyeong Hwa, Baek Hye Jin, Hwang Soo Hyun, Kwon O-Ki
Department of Neurosurgery, Gyeongsang National University Changwon Hospital, Seongsan-gu, Changwon-si, Gyeongsangnam-do, Republic of Korea.
Department of Neurosurgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju-Si, Republic of Korea.
World Neurosurg. 2020 Mar;135:e710-e715. doi: 10.1016/j.wneu.2019.12.110. Epub 2019 Dec 27.
Coil protrusion occasionally occurs during embolization and can lead to thromboembolic complications. We aimed to evaluate the efficacy of rescue stenting procedures with a low-profile stent system (LVIS Jr.) for treating ruptured intracranial aneurysms during complicated coil embolization.
We performed a retrospective review to identify patients who had subarachnoid hemorrhage and were treated with LVIS Jr. stent rescue therapy. We enrolled 15 patients with intracranial aneurysms and evaluated the technical success and immediate postprocedural clinical and angiographic outcomes.
All 15 patients underwent successful rescue-stent treatment, and no thrombotic or hemorrhagic complications occurred. Immediate postprocedural angiography revealed complete aneurysm occlusion in 40% (6/15) of the patients, whereas 60% (9) of the patients had a residual neck. Among the 12 patients who underwent follow-up angiography, 10 (83.3%) patients had complete aneurysm occlusion, 1 (8.3%) had a residual neck, and 1 (8.3%) showed an increase in the filling status of the aneurysm. There were no thrombotic complications during the follow-up period.
Our findings indicate that LVIS Jr. stent rescue therapy is clinically useful for handling coil protrusion during the embolization of ruptured intracranial aneurysms.
在栓塞过程中偶尔会发生弹簧圈突出，并可能导致血栓栓塞并发症。我们旨在评估使用低轮廓支架系统（LVIS Jr.）进行补救性支架置入术治疗破裂颅内动脉瘤复杂弹簧圈栓塞的疗效。
我们进行了一项回顾性研究，以确定蛛网膜下腔出血并接受LVIS Jr.支架补救治疗的患者。我们纳入了15例颅内动脉瘤患者，并评估了技术成功率以及术后即刻的临床和血管造影结果。
所有15例患者均成功接受了补救性支架治疗，未发生血栓形成或出血并发症。术后即刻血管造影显示40%（6/15）的患者动脉瘤完全闭塞，而60%（9例）的患者有残余瘤颈。在接受随访血管造影的12例患者中，10例（83.3%）患者动脉瘤完全闭塞，1例（8.3%）有残余瘤颈，1例（8.3%）动脉瘤充盈状态增加。随访期间无血栓形成并发症。
我们的研究结果表明，LVIS Jr.支架补救治疗在临床上可有效处理破裂颅内动脉瘤栓塞过程中的弹簧圈突出。
