Department of Neurointerventional Radiology, School of Medicine, Stanford University, California, United States of America; Departments of Neurosurgery and Imaging, Monash Health, Melbourne, Victoria, Australia; School of Clinical Sciences, Faculty of Medicine Nursing and Health Sciences, Monash University, Victoria, Australia.
Department of Neurointerventional Radiology, School of Medicine, Stanford University, California, United States of America.
J Clin Neurosci. 2024 Nov;129:110852. doi: 10.1016/j.jocn.2024.110852. Epub 2024 Sep 28.
Intracranial pseudoaneurysms account for approximately 1% of all intracranial aneurysms and are associated with high rebleeding risk and mortality. Traditional treatments of these lesions include microsurgical or endovascular reconstruction and parent vessel sacrifice. Reconstruction of the vessel is challenging due to poor vessel integrity and incomplete wall structure. An alternative endovascular reconstructive treatment includes deployment of a covered stent. Original covered stents such as the Jostent Graftmaster and the Willis stent suffer from stiff constructs that limit deployment in tortuous anatomy. The PK Papyrus covered coronary stent may be a satisfactory treatment alternative for these lesions. We present a case of an enlarging traumatic distal cavernous segment internal carotid artery pseudoaneurysm treated with trans-radial deployment of a PK Papyrus stent at our institution. We propose that the PK Papyrus covered stent may be an alternative reconstructive endovascular treatment for intracranial pseudoaneurysms. Further larger scale prospective case series would provide further support for this management strategy.
颅内假性动脉瘤约占所有颅内动脉瘤的 1%,与高再出血风险和高死亡率相关。这些病变的传统治疗方法包括显微手术或血管内重建和载瘤动脉牺牲。由于血管完整性差和壁结构不完整,血管重建具有挑战性。一种替代的血管内重建治疗方法包括放置覆膜支架。原始的覆膜支架,如 Jostent Graftmaster 和 Willis 支架,由于其僵硬的结构,限制了在迂曲解剖中的部署。PK Papyrus 覆膜冠状动脉支架可能是这些病变的一种满意的治疗选择。我们在本院报告了 1 例创伤性远端海绵窦段颈内动脉假性动脉瘤进行经桡动脉部署 PK Papyrus 支架治疗的病例。我们提出,PK Papyrus 覆膜支架可能是颅内假性动脉瘤的一种替代血管内重建治疗方法。进一步的大规模前瞻性病例系列研究将为这种治疗策略提供更多支持。