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Comaneci 辅助弹簧圈栓塞术治疗右侧后交通动脉瘤:线圈滞留的罕见病例。

Comaneci-assisted coiling of a right posterior communicating artery aneurysm: an unusual case of coil retention.

机构信息

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.

出版信息

J Neurointerv Surg. 2023 Dec;15(12):1286. doi: 10.1136/jnis-2022-020045. Epub 2023 Apr 4.

Abstract

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 .

摘要

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

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