Neurosurgery Department, Beijing Tsinghua Chang gung Hospital, School of Clinical Medicine, Tsinghua University, PR China.
Neuroradiol J. 2020 Dec;33(6):517-519. doi: 10.1177/1971400920941192. Epub 2020 Jul 16.
Flow diversion in the acute phase of aneurysm rupture or giant aneurysm is limited by the need for dual antiplatelet therapy and the risk of delayed aneurysm rupture. Here, the authors report a scheduled flow-diversion concept for the endovascular treatment of a giant intra-dural aneurysm.
A 54-year-old female patient with a ruptured giant middle cerebral artery aneurysm underwent coiling in the acute phase following 1-month scheduled Pipeline flex placement.
The acutely ruptured giant middle cerebral artery aneurysm was treated by flow diversion scheduled at 1 month after conventional coiling. The patient tolerated this treatment strategy well without any neurological deficits after the procedure and during the 3-month follow-up. The aneurysm showed nearly complete obliteration on 3-month follow-up angiogram, and a 6- to 12-month follow-up was scheduled.
This strategy may be considered as an option in patients presenting with ruptured or unruptured giant intra-dural aneurysms.
在动脉瘤破裂或巨大动脉瘤的急性期进行血流改道受到双重抗血小板治疗的需求和延迟动脉瘤破裂风险的限制。在此，作者报告了一种计划中的血流导向概念，用于治疗巨大硬脑膜内动脉瘤的血管内治疗。
一名 54 岁女性患者，急性破裂巨大大脑中动脉动脉瘤，在 1 个月计划的 Pipeline flex 放置后进行急性 coil 治疗。
急性破裂的巨大大脑中动脉动脉瘤通过在常规 coil 治疗后 1 个月进行的血流导向治疗。该患者在手术后和 3 个月随访期间无任何神经功能缺损，耐受了这种治疗策略。3 个月随访时动脉瘤显示几乎完全闭塞，计划进行 6-12 个月随访。
对于破裂或未破裂的巨大硬脑膜内动脉瘤患者，该策略可作为一种选择。
