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[血流导向装置治疗颅内动脉瘤]

[Treatment of intracranial aneurysms with flow diverters].

作者信息

Simgen A

机构信息

Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Str. 1, 66424, Homburg/Saar, Deutschland.

出版信息

Radiologe. 2020 Apr;60(4):303-309. doi: 10.1007/s00117-020-00662-w.

Abstract

CLINICAL ISSUE

The clinical picture of a subarachnoid haemorrhage (SAH) is associated with a high morbidity and mortality, due to the associated complications. Therefore, both unruptured and ruptured aneurysms are to be treated based on an individual and interdisciplinary treatment concept. Several endovascular procedures are already available for the treatment of intracranial aneurysms. A more recent concept is the treatment with vessel-reconstructive stents so-called flow diverters.

PRACTICAL RECOMMENDATIONS

Due to the continuous development and revision of flow diverters, the initial complication rates have been significantly reduced, which now effectively and efficiently justifies their clinical use. After careful patient selection and risk-benefit assessment, the implantation of a flow diverter can also be considered for the treatment of ruptured aneurysms and is often the only therapy option in such situations.

摘要

临床问题

蛛网膜下腔出血(SAH)的临床表现与高发病率和死亡率相关,这是由相关并发症所致。因此,未破裂和已破裂的动脉瘤均应基于个体化和多学科治疗理念进行治疗。目前已有多种血管内介入手术可用于治疗颅内动脉瘤。一种较新的理念是使用所谓的血流导向装置——血管重建支架进行治疗。

实际建议

由于血流导向装置不断发展和改进,其初始并发症发生率已显著降低,这使其临床应用在有效性和效率方面都有了充分依据。在仔细进行患者选择和风险效益评估后,也可考虑植入血流导向装置来治疗破裂动脉瘤,而且在这种情况下它往往是唯一的治疗选择。

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