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颅内动脉粥样硬化疾病伴大血管闭塞，采用Pipeline栓塞装置治疗进行次最大血管成形术后出现基底动脉近端出血。

Proximal basilar artery hemorrhage after submaximal angioplasty for intracranial atherosclerotic disease presenting as a large vessel occlusion treated with pipeline embolization device.

作者信息

Johnson Ryan M, Young Michael, Guglielmi Gina N, Farhat Hamad

机构信息

Department of Neurosurgery, Carle BroMenn Medical Center, Normal, IL, USA.

Department of Neurosurgery, Advocate Christ Medical Center, Oak Lawn, IL, USA.

出版信息

J Cerebrovasc Endovasc Neurosurg. 2021 Jun;23(2):145-151. doi: 10.7461/jcen.2021.E2020.11.005. Epub 2021 Jun 17.

DOI:10.7461/jcen.2021.E2020.11.005
PMID:34134445
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8256018/
Abstract

Iatrogenic vessel perforation from endovascular intervention is a devastating complication that commonly is treated with vessel sacrifice. We present a unique case of an iatrogenic proximal basilar artery perforation after submaximal angioplasty in a 67-year-old male presenting with an acute basilar artery occlusion with underlying intracranial atherosclerotic disease. Telescoping flow-diverting stents were then deployed to reconstruct the vessel wall with resulting active hemorrhage resolution. Our case documents a successful deployment of flow-diverting stents with resolution of active hemorrhage after an iatrogenic basilar artery perforation.

摘要

血管内介入治疗导致的医源性血管穿孔是一种严重的并发症，通常采用牺牲血管的方法进行治疗。我们报告了一例独特的病例，一名67岁男性，患有急性基底动脉闭塞并伴有颅内动脉粥样硬化疾病，在进行次最大程度血管成形术后发生医源性近端基底动脉穿孔。随后部署了可伸缩血流导向支架来重建血管壁，从而成功解决了活动性出血问题。我们的病例记录了在医源性基底动脉穿孔后成功部署血流导向支架并解决活动性出血的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a5a/8256018/d7be2fb53ef8/jcen-2021-e2020-11-005f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a5a/8256018/0bee6a33b57f/jcen-2021-e2020-11-005f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a5a/8256018/99e8c9190f97/jcen-2021-e2020-11-005f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a5a/8256018/987c1781f125/jcen-2021-e2020-11-005f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a5a/8256018/6f72e1904247/jcen-2021-e2020-11-005f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a5a/8256018/d7be2fb53ef8/jcen-2021-e2020-11-005f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a5a/8256018/0bee6a33b57f/jcen-2021-e2020-11-005f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a5a/8256018/99e8c9190f97/jcen-2021-e2020-11-005f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a5a/8256018/987c1781f125/jcen-2021-e2020-11-005f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a5a/8256018/6f72e1904247/jcen-2021-e2020-11-005f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a5a/8256018/d7be2fb53ef8/jcen-2021-e2020-11-005f5.jpg

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本文引用的文献

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Submaximal angioplasty in the treatment of patients with symptomatic ICAD: a systematic review and meta-analysis.症状性颅内动脉粥样硬化狭窄患者的次全血管成形术治疗:系统评价和荟萃分析。
J Neurointerv Surg. 2020 Apr;12(4):380-385. doi: 10.1136/neurintsurg-2019-015451. Epub 2019 Nov 20.
2
Endovascular and Clinical Outcomes of Vertebrobasilar Intracranial Atherosclerosis-Related Large Vessel Occlusion.椎基底动脉颅内动脉粥样硬化相关大血管闭塞的血管内治疗及临床结局
Front Neurol. 2019 Mar 19;10:215. doi: 10.3389/fneur.2019.00215. eCollection 2019.
3
Technical factors affecting outcomes following endovascular treatment of posterior circulation atherosclerotic lesions.
影响后循环动脉粥样硬化病变血管内治疗效果的技术因素。
Surg Neurol Int. 2017 Nov 20;8:284. doi: 10.4103/sni.sni_255_17. eCollection 2017.
4
Use of the Pipeline embolization device in the treatment of iatrogenic intracranial vascular injuries: a bi-institutional experience.管道栓塞装置在医源性颅内血管损伤治疗中的应用：一项双机构经验。
Neurosurg Focus. 2017 Jun;42(6):E9. doi: 10.3171/2017.3.FOCUS1735.
5
Acute Basilar Artery Occlusion: Differences in Characteristics and Outcomes after Endovascular Therapy between Patients with and without Underlying Severe Atherosclerotic Stenosis.急性基底动脉闭塞：合并与不合并严重动脉粥样硬化狭窄的患者接受血管内治疗后的特征及预后差异
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6
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