Phuyal Subash, Lamichhane Saurav, Mishra Biswamohan, Nayak Manoj Kumar
Department of Neuroradiology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Kathmandu, Nepal.
Department of Neurology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
J Neurosci Rural Pract. 2023 Jul-Sep;14(3):528-530. doi: 10.25259/JNRP_23_2023. Epub 2023 Jul 14.
A 42-year-old female presented with sudden onset severe headache without loss of consciousness 4 days back. Non-contrast computed tomography scan of the brain showed subarachnoid hemorrhage, and angiography showed a wide-necked aneurysm in the right middle cerebral artery (MCA) bifurcation, incorporating the superior division of right M2 MCA and another small aneurysm in the inferior division of right M2 MCA. Because of the wide-necked ruptured aneurysm and another in the inferior division of right M2 MCA, braided stent-assisted coiling (Leo baby) with shelving was done to protect both the aneurysms and to protect the superior branch of M2 MCA. The patient tolerated the procedure well and had an uneventful recovery. In this report, we have also reviewed and discussed the challenges, advantages, and disadvantages of the newly discovered shelving technique with a braided stent for wide-necked bifurcation aneurysms.
一名42岁女性于4天前突发剧烈头痛，无意识丧失。脑部非增强计算机断层扫描显示蛛网膜下腔出血，血管造影显示右侧大脑中动脉（MCA）分叉处有一个宽颈动脉瘤，累及右侧M2 MCA上支，右侧M2 MCA下支还有另一个小动脉瘤。由于宽颈破裂动脉瘤以及右侧M2 MCA下支的另一个动脉瘤，采用带搁置技术的编织支架辅助弹簧圈栓塞术（Leo baby）来保护两个动脉瘤以及M2 MCA的上支。患者对该手术耐受性良好，恢复顺利。在本报告中，我们还回顾并讨论了新发现的用于宽颈分叉动脉瘤的带编织支架搁置技术的挑战、优点和缺点。
