Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou Medical University, Shandong, P. R. China.
J Craniofac Surg. 2024;35(5):1549-1551. doi: 10.1097/SCS.0000000000010374. Epub 2024 May 30.
Wide-neck aneurysm embolism is a technically demanding procedure. Stent device deployment is challenging intraoperatively, especially in parent arteries with acute angles.
The authors describe the case of a 74-year female with an unruptured right posterior inferior cerebellar artery aneurysm. The acute angle of the arteries proximal to the posterior inferior cerebellar artery complicated the condition, and the distal end of the guidewire failed to enter the posterior inferior cerebellar artery despite several maneuvers. The wide neck of the aneurysm was located in the posterior inferior cerebellar artery, so a stent was needed. The stent was deployed from the left vertebral artery retrograde to the right vertebral artery.
The authors report the successful application of a rare strategy, the radial approach combined with a contralateral vertebral retrograde approach, for stent deployment.
宽颈动脉瘤栓塞是一项技术要求很高的操作。支架器械的植入在术中极具挑战性,尤其是在近端血管呈锐角的情况下。
作者描述了一位 74 岁女性右侧后下小脑动脉未破裂动脉瘤的病例。该患者动脉近端的锐角使情况变得复杂,尽管进行了多次操作,导丝的远端仍未能进入后下小脑动脉。动脉瘤的宽颈位于后下小脑动脉内,因此需要支架。支架从左侧椎动脉逆行植入到右侧椎动脉。
作者报告了一种罕见策略的成功应用,即桡动脉入路联合对侧椎动脉逆行入路进行支架植入。