Kinariwala Jay P, Rajah Gary B, Vaidya Rahul, Narayanan Sandra
Department of Neurology, Wayne State University, Detroit, MI, USA.
Department of Neurosurgery, Wayne State University, Detroit, MI, USA.
Brain Circ. 2020 Feb 18;6(1):52-56. doi: 10.4103/bc.bc_18_19. eCollection 2020 Jan-Mar.
There are several methods to achieve the therapeutic sacrifice of the vessel, coiling brings the most commonly used. Penumbra occlusion device (POD) system is a newer modality for therapeutic large vessel occlusion, and it is the Food and Drug Administration approved only for peripheral vessels. We report a case where therapeutic vertebral artery (VA) occlusion was achieved with the POD system and Ruby coils for the first time. A patient was diagnosed with a new malignant-appearing tumor of the cervical spine. A conventional angiogram showed multiple tiny arterial feeders from the VA beyond scope of coil/onyx embolization, so we performed a balloon occlusion test followed by therapeutic sacrifice of the VA. A successful VA occlusion was achieved with significant reduction in the tumor blush, followed by open resection of the tumor. The patient had favorable postoperative course and without any neurological symptoms attributed to the VA occlusion.
实现血管治疗性闭塞有多种方法，其中弹簧圈栓塞是最常用的。半影闭塞装置（POD）系统是一种用于治疗性大血管闭塞的较新方式，且仅获美国食品药品监督管理局批准用于外周血管。我们首次报告了一例使用POD系统和红宝石弹簧圈实现椎动脉（VA）治疗性闭塞的病例。一名患者被诊断出颈椎出现新的疑似恶性肿瘤。常规血管造影显示椎动脉有多个微小动脉分支超出了弹簧圈/奥尼克斯栓塞范围，因此我们进行了球囊闭塞试验，随后对椎动脉进行治疗性闭塞。成功实现了椎动脉闭塞，肿瘤造影剂外渗显著减少，随后对肿瘤进行了开放切除。患者术后恢复良好，未出现任何归因于椎动脉闭塞的神经症状。
