学龄前儿童脑血管痉挛的球囊血管成形术
Balloon angioplasty for cerebral vasospasm in preschool children.
作者信息
Demartini Zeferino, Requejo Flavio, Beraldo Renato Fedato, Maeda Adriano Keijiro, Savoldi Alexandre Mello, Cardoso-Demartini Adriane
机构信息
Complexo Hospital de Clinicas - UFPR - Department of Neurosurgery, Curitiba - PR, Brazil.
Hospital Pequeno Principe - Department of Neurosurgery, Curitiba - PR, Brazil.
出版信息
Interv Neuroradiol. 2024 Nov 15:15910199241293173. doi: 10.1177/15910199241293173.
BACKGROUND
Subarachnoid hemorrhage evolving with cerebral vasospasm and delayed cerebral ischemia may increase morbidity and mortality. Treating vasospasm with balloon percutaneous angioplasty (PTA) in adults is well known, but data in preschool children are scarce. In addition, the smaller diameters and fragility of the vessels in childhood might lead to serious complications. This study presents two cases of cerebral vasospasm in preschool children treated with balloon PTA. Therefore, it may contribute to a better understanding of the role of that technique as an effective treatment modality in this population.
METHODS
Balloon PTA was performed in two children (3 and 4 year-old) with aneurysmal subarachnoid hemorrhage and delayed cerebral ischemia.
RESULTS
The procedures were uneventful, and both patients survived without complications or new infarction.
CONCLUSIONS
Balloon PTA for proximal vasospasm may improve clinical outcomes in selected pediatric patients. Further studies are needed to clarify the best candidates, materials, and techniques.
背景
蛛网膜下腔出血伴发脑血管痉挛和迟发性脑缺血会增加发病率和死亡率。在成人中，使用球囊经皮血管成形术（PTA）治疗血管痉挛是众所周知的，但学龄前儿童的数据却很稀少。此外，儿童血管直径较小且脆弱，可能会导致严重并发症。本研究展示了两例接受球囊PTA治疗的学龄前儿童脑血管痉挛病例。因此，它可能有助于更好地理解该技术在这一人群中作为一种有效治疗方式的作用。
方法
对两名患有动脉瘤性蛛网膜下腔出血和迟发性脑缺血的儿童（3岁和4岁）进行了球囊PTA治疗。
结果
手术过程顺利，两名患者均存活，无并发症或新的梗死。
结论
球囊PTA治疗近端血管痉挛可能会改善部分儿科患者的临床结局。需要进一步研究以明确最佳候选患者、材料和技术。
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