Stanzani Riccardo, Yamada Yasuhiro, Kawase Tukasa, Devareddy Gowtham, Kadam Chandratej, Shukurov Firuz, Vaibhav Chavan, Kato Yoko
Department of Neurosurgery, Neurosurgery Unit AOU Policlinico di Modena - OCSAE Modena Hospital, Modena, Italy.
Department of Neurosurgery, Neurosurgical Residency Program, University of Padua, Padua, Italy.
Asian J Neurosurg. 2020 May 29;15(2):428-430. doi: 10.4103/ajns.AJNS_349_19. eCollection 2020 Apr-Jun.
We describe an uncommon case of acute coils migration with significant occlusion of M3 branch and our management of this complication. Ballon-assisted coil placement was performed for an unruptured intracavernous internal carotid artery aneurysm in a 62-year-old woman. After coil placement and balloon deflection, we observed coils migration with significant occlusion of M3 branch. After early clinical deterioration without other neurological symptoms, we decided to perform superficial temporal artery-middle cerebral artery (STA-MCA) bypass to ensure blood flow distal to the occlusion. The patient was discharged without neurological deficit. To the best of our knowledge, this is the first case report about STA-MCA bypass to treat acute coils migration. This technique could represent a successful rescue therapy in case of acute coils migration that cannot be retrieved by endovascular tools or in case where distal and deep location of migrated coils controindicate surgical removal.
我们描述了一例罕见的急性弹簧圈移位病例，该病例导致大脑中动脉M3分支严重闭塞，并介绍了我们对这一并发症的处理方法。对一名62岁女性的未破裂海绵窦段颈内动脉瘤进行了球囊辅助弹簧圈置入术。在弹簧圈置入和球囊放气后，我们观察到弹簧圈移位，导致M3分支严重闭塞。在早期临床病情恶化且无其他神经症状后，我们决定进行颞浅动脉-大脑中动脉（STA-MCA）搭桥手术，以确保闭塞远端的血流。患者出院时无神经功能缺损。据我们所知，这是第一例关于STA-MCA搭桥手术治疗急性弹簧圈移位的病例报告。对于无法通过血管内工具取出的急性弹簧圈移位，或者移位弹簧圈位于远端和深部而禁忌手术切除的情况，该技术可能是一种成功的挽救治疗方法。
