Wang Hao, Zhang Jingyu, Yang Huajiang, Zeng Shi, Guo Tengyun, Xu Lunshan, Yang Donghong
Department of Neurosurgery, Army Medical Center of PLA, Chongqing, China.
Department of Neurosurgery, People's Hospital of Chongqing Banan District, Chongqing, China.
Front Neurol. 2024 Jan 19;14:1247549. doi: 10.3389/fneur.2023.1247549. eCollection 2023.
Endovascular or surgical treatment of wide-neck, large basilar apex aneurysms is challenging. We present a novel concept for the treatment of complex basilar apex aneurysms using flow-diverter devices combined with the flow-T stenting-assisted coiling technique. Assess the efficacy and safety profile of the technique in this complex aneurysm.
A patient with multiple unruptured intracranial aneurysms underwent staged treatment. A large basilar apex aneurysm was treated with a flow-diverter stent combined with a flow-T stenting-assisted coiling technique in the first stage, and a giant supraclinoid aneurysm was treated with a flow-diverter stent applied in the second stage. Clinical presentations, technical details, intra- and perioperative complications, and clinical and angiographic outcomes were recorded, with a 9-month follow-up.
The patient achieved full neurologic recovery postoperatively. Cerebral angiography performed postoperatively showed revascularization, good laminar flow, and no in-stent or adjacent stenosis.
Flow-diverter stents combined with flow-T stenting-assisted coiling for the treatment of giant basilar apex aneurysms is a feasible technique with efficacy demonstrated at a 9-month follow-up. Staged endovascular treatment of multiple intracranial aneurysms may be a safe and viable option.
宽颈、大型基底动脉尖部动脉瘤的血管内治疗或外科治疗具有挑战性。我们提出一种使用血流导向装置结合血流-T 支架辅助弹簧圈栓塞技术治疗复杂基底动脉尖部动脉瘤的新概念。评估该技术在这种复杂动脉瘤中的疗效和安全性。
一名患有多个未破裂颅内动脉瘤的患者接受了分期治疗。第一期采用血流导向支架结合血流-T 支架辅助弹簧圈栓塞技术治疗大型基底动脉尖部动脉瘤，第二期采用血流导向支架治疗巨大床突上动脉瘤。记录临床表现、技术细节、术中和围手术期并发症以及临床和血管造影结果，并进行 9 个月的随访。
患者术后实现了完全神经功能恢复。术后脑血管造影显示血管再通、层流良好，且无支架内或相邻部位狭窄。
血流导向支架结合血流-T 支架辅助弹簧圈栓塞治疗巨大基底动脉尖部动脉瘤是一种可行的技术，9 个月随访显示有效。颅内多发动脉瘤的分期血管内治疗可能是一种安全可行的选择。
