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植入手术后12天,编织型血管内桥接物从动脉瘤中脱出:病例展示

A Woven EndoBridge dislodging from an aneurysm 12 days after the implantation procedure: illustrative case.

作者信息

Kanazawa Ryuzaburo, Uchida Takanori, Higashida Tetsuhiro, Kono Takao, Ebise Hiroki, Kuniyoshi Noboru

机构信息

Departments of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, Japan.

Departments of General Internal Medicine, Nagareyama Central Hospital, Nagareyama, Chiba, Japan.

出版信息

J Neurosurg Case Lessons. 2024 Oct 14;8(16). doi: 10.3171/CASE24278.

Abstract

BACKGROUND

The Woven EndoBridge (WEB) is an effective embolization device. A few cases of WEB migration have been reported as adverse events, and most occurred during the procedure. A case of internal carotid artery (ICA) occlusion due to a trapped WEB, which occurred 12 days after the implantation procedure, is reported.

OBSERVATIONS

A woman in her 70s was referred for an enlarged left ICA aneurysm during follow-up. A WEB SL 5 × 3 was chosen as the embolic device, and the implantation procedure was completed uneventfully. The patient's postoperative course was good, and she was discharged from the hospital. However, 12 days later, she was brought to the authors' hospital because the WEB device was trapped and occluded in the left ICA. The trapped WEB could not be retrieved using a gooseneck snare or stent retriever, but suction from a Sofia catheter released the trapped device, allowing it to be repositioned within the aneurysm.

LESSONS

Most cases of WEB migration occur during surgery. In the present case, migration occurred 12 days after surgery, and to the best of the authors' knowledge, no similar cases have been reported. It is important to keep in mind that there are cases similar to the current case. https://thejns.org/doi/10.3171/CASE24278.

摘要

背景

编织型血管内桥接装置(WEB)是一种有效的栓塞装置。已有少数WEB移位病例被报告为不良事件,且大多数发生在手术过程中。本文报告了1例植入手术后12天因WEB被困导致颈内动脉(ICA)闭塞的病例。

观察结果

一名70多岁的女性在随访期间因左侧ICA动脉瘤增大前来就诊。选用WEB SL 5×3作为栓塞装置,植入手术顺利完成。患者术后恢复良好,出院。然而,12天后,她因WEB装置被困并阻塞在左侧ICA而被送至作者所在医院。使用鹅颈圈套器或支架取栓器无法取出被困的WEB,但通过Sofia导管抽吸使被困装置得以释放,从而能够将其重新放置在动脉瘤内。

经验教训

大多数WEB移位病例发生在手术期间。在本病例中,移位发生在手术后12天,据作者所知,尚未有类似病例的报道。必须牢记存在与当前病例类似的情况。https://thejns.org/doi/10.3171/CASE24278

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c72/11488370/697e389bbdfa/CASE24278_figure_1.jpg

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