Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Oper Neurosurg (Hagerstown). 2021 Jul 15;21(2):E109-E110. doi: 10.1093/ons/opab102.
Wide-necked bifurcation aneurysms pose technical and anatomical challenges to endovascular treatment, which make the simpler assisted (balloon or single stent) coiling techniques less effective.1 Consequently, unique endovascular solutions to treat such aneurysms have been devised.2,3 One such device is PulseRider (Cerenovus, New Brunswick, New Jersey), which is designed to provide neck support for a coil mass while protecting the bifurcation.3 The device comprises a body or stem that is deployed in the parent artery and a saddle component that sits at the aneurysm neck to keep the coil mass away from the bifurcation. There are several technical nuances involved in successful use of the device during positioning, deployment, and detachment.3 We present a surgical video detailing the steps of PulseRider-assisted coiling of unruptured basilar bifurcation (or basilar apex) aneurysms. The first case highlights index treatment at diagnosis and the second showcases treatment of a recurrent basilar apex aneurysm. Both patients provided informed consent to the procedure. We also briefly discuss the rationale for treating basilar apex aneurysms.4,5.
宽颈分叉部动脉瘤给血管内治疗带来了技术和解剖上的挑战，使得更为简单的辅助（球囊或单支架）弹簧圈技术效果较差。1 因此，人们设计了独特的血管内解决方案来治疗此类动脉瘤。2,3 其中一种器械是 PulseRider（Cerenovus，新泽西州新不伦瑞克），它旨在为线圈团提供颈部支撑，同时保护分叉部。3 该器械由一个在母动脉中展开的主体或主干以及一个位于动脉瘤颈部的鞍状部件组成，用于将线圈团与分叉部隔开。在定位、展开和分离过程中，成功使用该器械需要注意几个技术细节。3 我们呈现了一个手术视频，详细介绍了 PulseRider 辅助治疗未破裂的基底分叉部（或基底顶端）动脉瘤的步骤。第一个病例突出显示了诊断时的初始治疗，第二个病例展示了治疗复发性基底顶端动脉瘤的情况。两位患者均对该手术表示知情同意。我们还简要讨论了治疗基底顶端动脉瘤的基本原理。4,5.
