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成功使用LVIS装置治疗血管分叉处未破裂的小脑上动脉远端动脉瘤。

Successful use of an LVIS device to treat unruptured distal aneurysm of the superior cerebellar artery at a vascular bifurcation.

作者信息

Yoshida Shinichiro, Maruyama Kousei, Kuwajima Takuto, Hama Yoshiaki, Morita Hiroya, Ota Yuichiro, Tashiro Noriaki, Hiraoka Fumihiro, Kawano Hiroto, Yano Shigetoshi, Aikawa Hiroshi, Go Yoshinori, Kazekawa Kiyoshi

机构信息

Department of Neurosurgery, Fukuoka Neurosurgical Hospital, Fukuoka, Japan.

Department of Neurosurgery, Go Neurosurgical Clinic, Fukuoka, Japan.

出版信息

Surg Neurol Int. 2022 May 20;13:208. doi: 10.25259/SNI_201_2022. eCollection 2022.

Abstract

BACKGROUND

Aneurysms of the distal superior cerebellar artery (SCA) account for only a small proportion of all cerebral aneurysms. Reports of the use of flow diverters (FDs) started to appear in 2013. We obtained good results from placement of a low-profile visualized intraluminal support device (LVIS) to treat unruptured distal aneurysm of the SCA at a vascular bifurcation.

CASE DESCRIPTION

A 65-year-old man presented at our hospital with sudden peripheral facial nerve palsy and suspected subarachnoid hemorrhage. Investigational cerebral angiography revealed an aneurysm at the bifurcation of the caudal and rostral trunks of the SCA. An LVIS was placed with the aim of obtaining flow diversion, and cerebral angiography 6 months after this procedure showed disappearance of aneurysm with preservation of the distal SCA.

CONCLUSION

Twelve cases of the use of FDs to treat aneurysms of the SCA have been reported previously. However, none of those reports described FD use to treat an aneurysm at a vascular bifurcation, as in the present case. Our results suggested that LVIS placement with the aim of obtaining flow diversion may be useful for the treatment of aneurysms at such sites.

摘要

背景

小脑上动脉(SCA)远端动脉瘤在所有脑动脉瘤中仅占一小部分。关于使用血流导向装置(FD)的报道始于2013年。我们通过植入低轮廓可视化腔内支撑装置(LVIS)治疗血管分叉处未破裂的SCA远端动脉瘤取得了良好效果。

病例描述

一名65岁男性因突发周围性面神经麻痹并疑似蛛网膜下腔出血入住我院。脑血管造影检查发现SCA尾侧和头侧干分叉处有一个动脉瘤。植入LVIS以实现血流导向,术后6个月的脑血管造影显示动脉瘤消失,SCA远端得以保留。

结论

此前已有12例使用FD治疗SCA动脉瘤的报道。然而,这些报道均未描述如本病例那样使用FD治疗血管分叉处的动脉瘤。我们的结果表明,以实现血流导向为目的植入LVIS可能对治疗此类部位的动脉瘤有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07a0/9168393/082198f3e9a5/SNI-13-208-g001.jpg

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