Sakata Hiroyuki, Ezura Masayuki, Kimura Naoto, Ishida Tomohisa, Inoue Takashi, Uenohara Hiroshi, Tominaga Teiji
Department of Neurosurgery, NHO Sendai Medical Center, Sendai, Miyagi, Japan.
Department of Neurosurgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan.
J Neuroendovasc Ther. 2021;15(5):310-315. doi: 10.5797/jnet.oa.2020-0152. Epub 2020 Dec 29.
There are several methods to treat wide-neck aneurysms. We survey the cases that were treated using a super-compliant double-lumen balloon microcatheter (Super-Masamune) for preservation of the branching vessel originating proximal to the aneurysm, especially in the bulging neck plasty (BNP) technique.
We assessed 10 cases in which branching vessel preservation was performed using Super-Masamune. The cases were categorized into three groups: (1) ordinary neck plasty (ONP): balloon microcatheter was navigated to the branch that should be preserved; (2) BNP: another branch was preserved by inflating balloon bulging without cannulation; (3) protection during parent artery occlusion (PPO): the balloon microcatheter was navigated to the vessel to be occluded. The balloon preserves a branch originating near the aneurysm without cannulating to the branch.
The aneurysm locations were as follows: internal carotid artery (ICA), three cases; anterior communicating artery (AcomA), one case; basilar artery (BA), three cases; and vertebral artery (VA), three cases. Four cases were ruptured aneurysms, while six cases were unruptured or ruptured in chronic stage. The ONP, BNP, and PPO groups contained two, five, and three cases, respectively. Embolization resulted in complete obliteration in six cases, neck remnant in two cases and body filling in two cases. No rupture/rerupture was noted in this series. One case showed an intraoperative rupture.
Super-Masamune is useful for neck plasty, especially BNP, in wide-neck aneurysms. Super-Masamune is also useful for parent artery occlusion when an important branch originates proximal to the aneurysm.
治疗宽颈动脉瘤有多种方法。我们对使用超顺应性双腔球囊微导管（Super - Masamune）治疗的病例进行了调查，以保留动脉瘤近端起源的分支血管，特别是在膨出颈部成形术（BNP）技术中。
我们评估了10例使用Super - Masamune进行分支血管保留的病例。这些病例分为三组：（1）普通颈部成形术（ONP）：将球囊微导管导航至应保留的分支；（2）BNP：通过充气使球囊膨出而不插管来保留另一分支；（3）母动脉闭塞时的保护（PPO）：将球囊微导管导航至要闭塞的血管。球囊保留动脉瘤附近起源的分支而不插入该分支。
动脉瘤位置如下：颈内动脉（ICA）3例；前交通动脉（AcomA）1例；基底动脉（BA）3例；椎动脉（VA）3例。4例为破裂动脉瘤，6例为未破裂或慢性期破裂动脉瘤。ONP、BNP和PPO组分别包含2例、5例和3例。栓塞后6例完全闭塞，2例颈部残留，2例瘤体填充。本系列中未观察到破裂/再破裂。1例出现术中破裂。
Super - Masamune对宽颈动脉瘤的颈部成形术，尤其是BNP很有用。当重要分支起源于动脉瘤近端时，Super - Masamune对母动脉闭塞也很有用。
