Department of Neuroradiology, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany.
Department of Neurology, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany.
J Clin Neurosci. 2020 May;75:210-212. doi: 10.1016/j.jocn.2020.02.026. Epub 2020 Mar 21.
Giant partially thrombosed aneurysms are challenging lesions for which treatment can be difficult due to their unfavourable anatomical configuration and abnormal flow conditions.
The patient presented in this report suffered from a symptomatic giant partially thrombosed donut-shaped aneurysm of the left-sided supraophthalmic internal carotid artery. Due to the location and the size of the aneurysm, endovascular treatment was performed. Navigation of the microcatheter-microwire-system distal to the aneurysm for stent deployment was technically not possible due to limited support, caused by the large aneurysm. Therefore, a WEB device was placed in the distal leg of the donut-shaped aneurysm. Additionally to the occlusion of this part of the aneurysm, the WEB device enabled enough support to navigate the microcatheter-microwire-system distal to the aneurysm. After deployment of a flow-diverting stent, coiling of the aneurysm was performed. Follow-up angiography showed complete occlusion of the aneurysm. The patient suffered from severe headaches which were no longer present 6 months after treatment.
The WEB intraaneurysmal flow diverter can be effectively used as combined support and embolization device for the treatment of complex aneurysms in selective cases where other catheterization and embolization strategies have failed.
巨大部分血栓形成的动脉瘤是具有挑战性的病变，由于其不利的解剖结构和异常的血流条件，治疗可能很困难。
本报告中介绍的患者患有症状性左眶上内颈动脉左侧部分血栓形成的环形巨大动脉瘤。由于动脉瘤的位置和大小，进行了血管内治疗。由于动脉瘤较大，微导管-微丝系统向动脉瘤远端导航用于支架放置的技术上是不可能的。因此，在环形动脉瘤的远端腿部放置了 WEB 装置。除了闭塞该部分动脉瘤外，WEB 装置还提供了足够的支撑力，使微导管-微丝系统能够向动脉瘤远端导航。在放置了一个血流导向支架后，对动脉瘤进行了填塞。随访血管造影显示动脉瘤完全闭塞。患者有严重的头痛，但在治疗 6 个月后不再出现。
WEB 腔内血流分流器可有效地用作复杂动脉瘤的联合支撑和栓塞装置，在其他导管和栓塞策略失败的情况下，选择性使用。
