Department of Neurology, Division of Neurocritical care, Emory University School of Medicine, Atlanta, GA, USA.
Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA.
Interv Neuroradiol. 2024 Apr;30(2):297-301. doi: 10.1177/15910199221105175. Epub 2022 May 29.
Aneurysmal recurrence after successful flow-diversion embolization is exceptionally rare. The rarity of recurrence has called into question the yield of interval surveillance imaging. Here we report the case of a recurrent intracranial aneurysm despite complete angiographic resolution after flow-diversion therapy with a Pipeline embolization device (PED). Given the absence of poor wall apposition, endoleak, and device migration, how this aneurysm recurred remains unclear, particularly given the recurrence was at a timepoint at which complete reendothelialization of the device would be expected. The patient ultimately underwent interval treatment with a second device placed across the neck of the aneurysm. Although rare, reports of aneurysmal recurrences support the use of interval non-invasive imaging surveillance to ensure successful embolization in this patient population.
颅内血流导向装置治疗后动脉瘤复发极为罕见。复发的罕见性使得对间隔期影像学监测的效果产生了质疑。本研究报告了一例颅内动脉瘤患者，在使用 Pipeline 栓塞装置（PED）进行血流导向治疗后完全血管造影消退后仍出现复发。鉴于没有不良的血管贴壁、内漏和器械迁移，该动脉瘤如何复发仍不清楚，特别是考虑到复发发生在完全内皮化的时间点。患者最终接受了间隔期治疗，在动脉瘤颈部放置了第二个装置。尽管罕见，但动脉瘤复发的报道支持对这一患者人群使用间隔期非侵入性影像学监测，以确保栓塞成功。
