Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China.
Interv Neuroradiol. 2021 Aug;27(4):511-515. doi: 10.1177/1591019920987913. Epub 2021 Jan 12.
Basilar artery perforator aneurysms (BAPAs) are rare. Traditional surgical clipping and endovascular coiling have proven to be challenging. We present three patients treated with endovascular electrothrombosis and describe the characteristics of this new approach.
Three patients presented with subarachnoid hemorrhages (SAHs). Cerebral angiography identified BAPAs. Endovascular electrothrombosis was performed after obtaining informed consent. We placed the microwire into the sac of the aneurysms through the microcatheter and connected its proximal tip to the Solitaire stent detachment system. Electrothrombosis was conducted using 1.0 mA current.
Two aneurysms were successfully occluded without treatment-related complication. The third one failed and converted to endovascular coiling using a 1.3-F microcatheter. The patient suffered brainstem infarction and finally died of severe SAH. At follow-up, the two patients were neurologically intact and angiography showed total occlusion of both aneurysms.
Endovascular electrothrombosis might be a potential alternative to traditional treatment for BAPAs. Close follow-up with caution should be mandatory. More research is needed to confirm its safety and efficacy.
基底动脉穿支动脉瘤（BAPAs）较为罕见。传统的手术夹闭和血管内栓塞已被证明具有挑战性。我们报告了 3 例接受血管内电凝血栓形成治疗的患者，并描述了这种新方法的特点。
3 例患者因蛛网膜下腔出血（SAH）就诊。脑血管造影确定为 BAPAs。在获得知情同意后，进行血管内电凝血栓形成。我们通过微导管将微丝放入动脉瘤囊内，并将其近端与 Solitaire 支架解脱系统连接。使用 1.0 mA 电流进行电凝血栓形成。
2 个动脉瘤成功闭塞，无治疗相关并发症。第 3 个动脉瘤治疗失败，改用 1.3-F 微导管进行血管内栓塞。患者发生脑干梗死，最终死于严重的 SAH。随访时，2 例患者神经功能完整，血管造影显示 2 个动脉瘤完全闭塞。
血管内电凝血栓形成可能是 BAPAs 传统治疗的一种潜在替代方法。应谨慎进行密切随访。需要进一步研究以确认其安全性和疗效。
