Feng Wei, Tian Xinhua, Kang Junlong, Han Zhaowei, Chen E
Department of Neurosurgery, Zhongshan Hospital Xiamen University, Xiamen 361004, China.
Brain Sci. 2023 Mar 3;13(3):435. doi: 10.3390/brainsci13030435.
Although endovascular treatment is a promising approach, blood blister-like aneurysms (BBAs) still present treatment challenges. This study aimed to assess the effectiveness and safety of flow diverter device-assisted coiling (FDDAC) for the treatment of BBAs, which are broad based and friable with a high rebleeding risk. Eight patients (five females and three males) who presented with subarachnoid hemorrhages (SAH) due to BBA ruptures between May 2020 and May 2022 were retrospectively enrolled. All patients were treated by flow diverter device (Tubridge) adjunctive coil embolization using a semi-deploying technique. The demographic information, angiographic data, interval between admission and treatment, materials, therapy, clinical outcomes (including periprocedural and intraprocedural mortality and morbidity), and follow-up results of all patients were reviewed. The mean age of the patients with BBAs was 48.5 years (range 31-62 years); aneurysm sizes ranged from 2.2 × 1.7 mm to 4.6 × 3.2 mm, and the median Hunt-Hess score was 3. All aneurysms were completely closed at follow-up, and all 8 patients had excellent clinical outcomes (modified Rankin scores = 0-2) at discharge. Angiograms showed complete aneurysm occlusion after 6 months to 1 year. In addition, there were no cases of re-rupture, re-treatment, or recurrence of the aneurysms. FDDAC is safe to use in patients with BBAs and provides an alternative treatment option for this disease.
尽管血管内治疗是一种很有前景的方法,但血泡样动脉瘤(BBAs)的治疗仍面临挑战。本研究旨在评估血流导向装置辅助弹簧圈栓塞术(FDDAC)治疗BBAs的有效性和安全性,BBAs基底较宽且质地脆弱,再出血风险高。回顾性纳入了2020年5月至2022年5月期间因BBA破裂导致蛛网膜下腔出血(SAH)的8例患者(5例女性和3例男性)。所有患者均采用半释放技术,使用血流导向装置(Tubridge)辅助弹簧圈栓塞治疗。回顾了所有患者的人口统计学信息、血管造影数据、入院与治疗间隔、材料、治疗方法、临床结局(包括围手术期和术中死亡率及发病率)以及随访结果。BBAs患者的平均年龄为48.5岁(范围31 - 62岁);动脉瘤大小范围为2.2×1.7mm至4.6×3.2mm,Hunt-Hess评分中位数为3分。随访时所有动脉瘤均完全闭塞,所有8例患者出院时临床结局均良好(改良Rankin评分 = 0 - 2)。血管造影显示6个月至1年后动脉瘤完全闭塞。此外,没有动脉瘤再破裂、再次治疗或复发的病例。FDDAC用于BBAs患者是安全的,为该病提供了一种替代治疗选择。