一名患有大型动脉瘤且合并动脉瘤远端颈内动脉狭窄的患者，对其实施了Pipeline Flex治疗。

A Patient with a Large Aneurysm Complicated by Stenosis of the Internal Carotid Artery Distal to the Aneurysm in Whom Treatment Using a Pipeline Flex Was Performed.

作者信息

Hiramatsu Ryo, Ohnishi Hiroyuki, Yagi Ryokichi, Kuroiwa Toshihiko, Wanibuchi Masahiko, Miyachi Shigeru

机构信息

Department of Neurosurgery and Endovascular Therapy, Osaka Medical College, Takatsuki, Osaka, Japan.

Ohnishi Neurological Center, Akashi, Hyogo, Japan.

出版信息

J Neuroendovasc Ther. 2020;14(11):501-507. doi: 10.5797/jnet.cr.2019-0129. Epub 2020 Aug 26.

OBJECTIVE

We report a case of in-stent stenosis as a complication at 6 months after the deployment of Pipeline Flex. This case necessitated retreatment for parent artery occlusion.

CASE PRESENTATION

A 55-year-old woman with right-side visual disorder was referred to our hospital for the deployment of Pipeline Flex. Cerebral digital subtraction angiography (DSA) demonstrated a large right-side paraclinoid aneurysm in combination with severe internal carotid artery (ICA) stenosis just beyond the aneurysm. We deployed Pipeline Flex under general anesthesia. After deployment, we performed angioplasty through the Pipeline. Six months after deployment, this patient exhibited exacerbation of visual disorder. Follow-up DSA revealed in-stent stenosis at 6 months after the deployment of Pipeline Flex. Therefore, we performed parent artery occlusion. Right-side visual disorder was improved in this patient.

CONCLUSION

If Pipeline is deployed for patients with ICA stenosis just beyond an aneurysm, we need to be aware of in-stent stenosis after deployment.

目的

我们报告1例在植入Pipeline Flex 6个月后出现支架内狭窄这一并发症的病例。该病例因载瘤动脉闭塞而需要再次治疗。

病例介绍

一名55岁右侧视力障碍女性因植入Pipeline Flex被转诊至我院。脑数字减影血管造影（DSA）显示右侧一个大型床突旁动脉瘤，且在动脉瘤远端合并严重颈内动脉（ICA）狭窄。我们在全身麻醉下植入了Pipeline Flex。植入后，我们通过该支架进行了血管成形术。植入6个月后，该患者视力障碍加重。随访DSA显示在植入Pipeline Flex 6个月后出现支架内狭窄。因此，我们实施了载瘤动脉闭塞术。该患者右侧视力障碍得到改善。