Department of Neurosurgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Korea.
Department of Neurosurgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 79 Gangnam-ro, Jinju 52727, Korea.
Medicina (Kaunas). 2022 Feb 5;58(2):240. doi: 10.3390/medicina58020240.
We report our experience in treating a ruptured dissecting posterior inferior cerebellar artery (PICA) aneurysm. To our knowledge, this is the first reported case of overlapping stenting without coils for a ruptured dissecting aneurysm of the proximal PICA. A 66-year-old male patient presented with sudden altered mental state and a subarachnoid hemorrhage (SAH). The cerebral angiography revealed a long segmental dissecting aneurysm on proximal PICA. Overlapping stents were deployed to the dissecting site, and angiogram showed intact distal PICA flow and decreased contrast staining in the dissecting site. Successful flow diversion was achieved with stents. Procedure-associated complications did not occur. The patient's postoperative course was uneventful. In follow-up cerebral angiography, dissecting aneurysm achieved complete remodeling. The decision that led to the choice of treatment is discussed.
我们报告了治疗破裂性小脑后下动脉（PICA）夹层动脉瘤的经验。据我们所知，这是首例报道的近端 PICA 破裂性夹层动脉瘤重叠支架置入而未使用线圈的病例。一名 66 岁男性患者突发精神状态改变和蛛网膜下腔出血（SAH）。脑血管造影显示近端 PICA 有一段长节段性夹层动脉瘤。将重叠支架置入夹层部位，血管造影显示远端 PICA 血流完整，夹层部位对比染色减少。支架成功实现了血流改道。没有发生与手术相关的并发症。患者术后恢复顺利。在随访脑血管造影中，夹层动脉瘤完全重塑。讨论了导致治疗选择的决策。
