Takong Wittawat, Kobkitsuksakul Chai
Neuroscience Center, Bangkok Pattaya Hospital, Chonburi, Thailand.
Division of Interventional Neuroradiology, Faculty of Medicine, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Neurointervention. 2020 Nov;15(3):154-157. doi: 10.5469/neuroint.2020.00220. Epub 2020 Sep 28.
A flow diverter can be used to treat a ruptured aneurysm, especially during complicated cases for endovascular or open microsurgical procedures. However, some complications have been reported such as occlusion of side branches or perforating arteries, stent migration or improper stent position, re-rupture of the aneurysm, and in-stent thrombosis. A 38-year-old man diagnosed with a ruptured left supraclinoid aneurysm was treated with a Pipeline embolization device. Despite adequate stent coverage of the aneurysmal neck, delayed proximal migration was seen in follow-up imaging. To our knowledge, proximal migration of the stent mostly happens intraoperatively due to an undersized stent or excessive stretching. We report a case of delayed proximal flow diverter stent migration.
血流导向装置可用于治疗破裂动脉瘤,尤其是在血管内或开放式显微外科手术的复杂病例中。然而,已报道了一些并发症,如侧支或穿支动脉闭塞、支架移位或支架位置不当、动脉瘤再破裂以及支架内血栓形成。一名38岁被诊断为左侧鞍上动脉瘤破裂的男性患者接受了Pipeline栓塞装置治疗。尽管动脉瘤颈部有足够的支架覆盖,但在随访影像中仍可见延迟性近端移位。据我们所知,支架近端移位大多在术中因支架尺寸过小或过度拉伸而发生。我们报告一例延迟性近端血流导向支架移位病例。