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伴有梗阻性脑积水的基底动脉巨大血栓性动脉瘤的治疗策略

Treatment strategy for giant thrombosed aneurysm of the basilar artery with associated obstructive hydrocephalus.

作者信息

Yoshida Shinichiro, Kamatani Kaisei, Maruyama Kousei, Hama Yoshiaki, Tashiro Noriaki, Hiraoka Fumihiro, Yano Shigetoshi, Aikawa Hiroshi, Go Yoshinori, Kazekawa Kiyoshi

机构信息

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

出版信息

Surg Neurol Int. 2023 Jan 20;14:23. doi: 10.25259/SNI_961_2022. eCollection 2023.

DOI:10.25259/SNI_961_2022
PMID:36751451
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9899459/
Abstract

BACKGROUND: There is no established adequate treatment for thrombosed aneurysm of the basilar artery with obstructive hydrocephalus. We conducted coil embolization and peritoneal shunting followed by placement of a stent expected to exert flow diversion (FD) effects to treat 2 patients with giant thrombosed aneurysms of the basilar artery with associated obstructive hydrocephalus, with good results. METHODS: From April 2019 to March 2021, consecutive two cases of symptomatic hydrocephalus due to giant thrombosed aneurysms in the posterior cranial fossa at our hospital were treated. At first, coil embolization was performed to prevent aneurysm rupture. After coil embolization, ventriculoperitoneal shunting was performed. Finally, stent-assisted coil embolization was performed with flow re-direction endoluminal device (FRED) or low-profile visualized intraluminal support device (LVIS) stent. RESULTS: Both patients were discharged after recovering well, with no postoperative hemorrhagic or ischemic complications. CONCLUSION: Staged surgery using a FRED for flow diverter or an LVIS stent expected to have FD effects may offer an effective treatment option.

摘要

背景：对于伴有梗阻性脑积水的基底动脉血栓性动脉瘤，尚无成熟的充分治疗方法。我们对2例伴有梗阻性脑积水的基底动脉巨大血栓性动脉瘤患者进行了弹簧圈栓塞和腹腔分流术，随后置入预期具有血流导向（FD）作用的支架，取得了良好效果。 方法：2019年4月至2021年3月，我院连续治疗了2例因后颅窝巨大血栓性动脉瘤导致的症状性脑积水患者。首先，进行弹簧圈栓塞以防止动脉瘤破裂。弹簧圈栓塞后，进行脑室腹腔分流术。最后，使用血流导向腔内装置（FRED）或低轮廓可视化腔内支撑装置（LVIS）支架进行支架辅助弹簧圈栓塞。 结果：两名患者均恢复良好后出院，无术后出血或缺血性并发症。 结论：使用具有血流导向作用的FRED或预期具有FD作用的LVIS支架进行分期手术可能提供一种有效的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa17/9899459/07fba13423b5/SNI-14-23-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa17/9899459/dd4e192b345c/SNI-14-23-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa17/9899459/6664b7b9ec02/SNI-14-23-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa17/9899459/a94ab70ee9fc/SNI-14-23-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa17/9899459/07fba13423b5/SNI-14-23-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa17/9899459/dd4e192b345c/SNI-14-23-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa17/9899459/6664b7b9ec02/SNI-14-23-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa17/9899459/a94ab70ee9fc/SNI-14-23-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa17/9899459/07fba13423b5/SNI-14-23-g004.jpg

相似文献

[1]
Treatment strategy for giant thrombosed aneurysm of the basilar artery with associated obstructive hydrocephalus.

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[2]
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[3]
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[5]
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[6]
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[7]
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Neurosurg Focus Video. 2022-10-1

[8]
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[9]
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Surg Neurol Int. 2021-7-12

[10]
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引用本文的文献

[1]
Successful surgical management of a recurrent thrombosed vertebral artery aneurysm following cardiopulmonary arrest induced by parent artery occlusion after flow diversion: illustrative case.

J Neurosurg Case Lessons. 2025-8-11

[2]
White blood cells, monocytes and thrombin time in predicting symptomatic hydrocephalus in patients with aneurysmal subarachnoid hemorrhage.

Front Surg. 2025-7-2

本文引用的文献

[1]
Antiplatelet Therapy in Flow Diversion.

Neurosurgery. 2020-1-1

[2]
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[3]
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J Neurosurg. 2017-11-10

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