Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA
Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA.
J Neurointerv Surg. 2023 Dec;15(12):1286. doi: 10.1136/jnis-2022-020045. Epub 2023 Apr 4.
Although endovascular embolization has become the main treatment option for intracranial aneurysms,1 2 wide-necked intracranial aneurysms remain difficult to coil.3 Both stent- and balloon-assisted coiling are used for wide-necked aneurysms because they provide a scaffold that protects the parent vessel during coiling.4 5 However, stent-assisted coiling requires dual antiplatelet therapy, which increases the risk of bleeding, whereas balloon-assisted coiling temporarily obstructs blood flow.4 6 7 The Comaneci device (Rapid Medical, Yokneam, Israel) has recently received US Food and Drug Administration approval as a 'temporary coil embolization assist device'.5 It temporarily covers the aneurysm neck and allows safe coiling, avoiding the disadvantages mentioned above.6-8 A potential complication of Comaneci-assisted coiling is coil retention when it adheres to the device on recapture; this complication should be promptly recognized and managed.5 9 10 In this video, we present an unusual case of coil retention with the Comaneci device (Video 1). neurintsurg;15/12/1286/V1F1V1Video 1 .
虽然血管内栓塞已成为颅内动脉瘤的主要治疗选择,1,2 但宽颈颅内动脉瘤仍然难以进行线圈填塞。3 支架辅助线圈填塞和球囊辅助线圈填塞均用于宽颈动脉瘤,因为它们在填塞过程中提供了一个保护载瘤血管的支架。4,5 然而,支架辅助线圈填塞需要双联抗血小板治疗,这会增加出血风险,而球囊辅助线圈填塞会暂时阻断血流。4,6,7 Comaneci 装置(Rapid Medical,以色列 Yokneam)最近获得美国食品和药物管理局批准,作为“临时线圈栓塞辅助装置”。5 它暂时覆盖动脉瘤颈部,允许安全填塞,避免了上述缺点。6-8 Comaneci 辅助线圈填塞的一个潜在并发症是在重新捕获时,线圈与装置粘连而导致线圈滞留;这种并发症应及时识别和处理。5,9,10 在这个视频中,我们展示了一例 Comaneci 装置线圈滞留的罕见病例(视频 1)。neurintsurg;15/12/1286/V1F1V1Video 1