Nampei Mai, Shiba Masato, Sakaida Hiroshi, Nakatsuka Yoshinari, Yasuda Ryuta, Toma Naoki, Suzuki Hidenori
Department of Neurosurgery, Saiseikai Matsusaka General Hospital, Matsusaka, Mie, Japan.
Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
J Neuroendovasc Ther. 2020;14(7):255-262. doi: 10.5797/jnet.cr.2019-0059. Epub 2020 Apr 9.
Subclavian artery aneurysms are relatively rare, and have been treated by open surgery and/or endovascular treatment using a stent graft. In this article, we report a case of unruptured right subclavian artery aneurysm successfully treated using balloon-assisted coil embolization.
A 77-year-old man was diagnosed with an asymptomatic unruptured right subclavian artery aneurysm of 8 mm in diameter by follow-up CTA after surgery for thoracoabdominal aortic aneurysms. He also had a history of cerebral infarction and clipping of an unruptured cerebral aneurysm. The subclavian artery aneurysm was treated by balloon-assisted coil embolization because its diameter increased to 17.6 mm in 2 years. Balloon assistance was mainly used to prevent protrusion of the framing coil into the parent artery, and satisfactory framing was achieved. Subsequently, the aneurysm was obliterated using filling and finishing coils. The postoperative course was uneventful, and the follow-up MRI at 18 months after treatment revealed no recanalization of the aneurysm.
Balloon-assisted coil embolization may be an effective treatment for subclavian artery aneurysms, but further long-term follow-up and case accumulation are needed.
锁骨下动脉瘤相对少见,以往通过开放手术和/或使用覆膜支架的血管腔内治疗。在本文中,我们报告1例采用球囊辅助弹簧圈栓塞成功治疗的未破裂右锁骨下动脉瘤病例。
一名77岁男性在胸腹主动脉瘤手术后接受CTA随访时被诊断为无症状的未破裂右锁骨下动脉瘤,直径8mm。他既往有脑梗死病史,曾行未破裂脑动脉瘤夹闭术。由于锁骨下动脉瘤直径在2年内增大至17.6mm,遂采用球囊辅助弹簧圈栓塞治疗。球囊辅助主要用于防止成篮弹簧圈突入载瘤动脉,并成功实现满意成篮。随后,使用填充和收尾弹簧圈闭塞动脉瘤。术后过程顺利,治疗后18个月的随访MRI显示动脉瘤无再通。
球囊辅助弹簧圈栓塞可能是治疗锁骨下动脉瘤的有效方法,但需要进一步的长期随访和病例积累。