Wang Zhengyu, Peng Zhiqing, Chen Liang, Li Wanbin, Wang Yongli
Department of Interventional Radiology, The Sixth People's Hospital South Campus, Shanghai Jiao Tong University, Shanghai, China.
J Interv Med. 2023 Jan 12;6(3):126-129. doi: 10.1016/j.jimed.2022.10.004. eCollection 2023 Aug.
Endovascular coil embolization is a minimally invasive, rapid, and effective method for the treatment of intracranial aneurysms. However, complications associated with coil embolization, such as intraoperative aneurysm rupture or arterial occlusion, should be promptly managed during the procedure to avoid catastrophic consequences. This study presents a case of mechanical compression management of the right middle cerebral artery (MCA) inferior trunk during coil embolization for bilateral MCA aneurysms. The inferior trunk of the right MCA was abruptly occluded due to mechanical compression during coil embolization of the right MCA bifurcation aneurysm. A Solitaire AB stent (4 × 20 mm, Covidien/Medtronic, Dublin, Ireland) was implanted in the inferior trunk of the right MCA after tirofiban was injected via a microcatheter, and the right inferior trunk was recanalized. The patient also underwent coil embolization of the left MCA bifurcation aneurysm, without any complications. It is crucial to recognize compressive occlusion of adjacent aneurysm branches to avoid severe complications during intracranial aneurysm embolization. Stent placement is a rescue treatment option for recanalization of an occluded artery.
血管内弹簧圈栓塞术是治疗颅内动脉瘤的一种微创、快速且有效的方法。然而，与弹簧圈栓塞相关的并发症，如术中动脉瘤破裂或动脉闭塞，在手术过程中应及时处理，以避免灾难性后果。本研究报告了一例在双侧大脑中动脉（MCA）动脉瘤弹簧圈栓塞术中对右侧大脑中动脉下干进行机械压迫处理的病例。在右侧大脑中动脉分叉部动脉瘤弹簧圈栓塞过程中，由于机械压迫，右侧大脑中动脉下干突然闭塞。在通过微导管注入替罗非班后，将一枚Solitaire AB支架（4×20 mm，柯惠/美敦力，都柏林，爱尔兰）植入右侧大脑中动脉下干，右侧下干再通。患者还接受了左侧大脑中动脉分叉部动脉瘤的弹簧圈栓塞术，未出现任何并发症。认识到相邻动脉瘤分支的压迫性闭塞对于避免颅内动脉瘤栓塞术中的严重并发症至关重要。支架置入是闭塞动脉再通的一种挽救治疗选择。
