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1例累及小脑后下动脉的椎动脉夹层动脉瘤，经对侧椎动脉在球囊保护下行动脉瘤栓塞及近端供血动脉闭塞治疗。

A Case of an Vertebral Artery Dissecting Aneurysm Involving the Posterior Inferior Cerebellar Artery Treated With Aneurysmal Embolization and Proximal Parent Artery Occlusion Under Balloon Protection via the Contralateral Vertebral Artery.

作者信息

Nakamura Takuya, Hanaoka Yoshiki, Koyama Jun-Ichi, Murata Takahiro, Kuroiwa Masafumi, Horiuchi Tetsuyoshi

机构信息

Neurosurgery, Shinshu University School of Medicine, Matsumoto, JPN.

Neurosurgery, Ina Central Hospital, Ina, JPN.

出版信息

Cureus. 2025 Jun 9;17(6):e85650. doi: 10.7759/cureus.85650. eCollection 2025 Jun.

DOI:10.7759/cureus.85650
PMID:40636657
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12240608/
Abstract

We experienced a case of subarachnoid hemorrhage due to a rupture of a vertebral artery dissecting aneurysm (VADA) involving the posterior inferior cerebellar artery (PICA) treated with a novel endovascular technique, which used a balloon catheter to protect the PICA origin via the contralateral vertebral artery. We performed coil embolization of the VADA and proximal parent artery occlusion via the ipsilateral vertebral artery under protection of the PICA. Using a balloon catheter instead of a stent, dense packing was achieved while preserving the PICA and avoiding hemorrhagic complications with stent-related antiplatelet therapy. Although further assessment is needed to clarify the potential risks and limitations, this technique can be a useful treatment option for VADA involving the PICA.

摘要

我们遇到了一例因椎动脉夹层动脉瘤（VADA）破裂导致蛛网膜下腔出血的病例，该动脉瘤累及小脑后下动脉（PICA），采用了一种新型血管内技术进行治疗，该技术使用球囊导管通过对侧椎动脉保护PICA起源。我们在PICA的保护下，通过同侧椎动脉对VADA进行了弹簧圈栓塞和近端供血动脉闭塞。使用球囊导管而非支架，在保留PICA的同时实现了致密填塞，并避免了支架相关抗血小板治疗引起的出血并发症。尽管需要进一步评估以明确潜在风险和局限性，但该技术对于累及PICA的VADA可能是一种有用的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cf6/12240608/552c39154186/cureus-0017-00000085650-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cf6/12240608/bd1f3648002c/cureus-0017-00000085650-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cf6/12240608/17d7bdae2ee6/cureus-0017-00000085650-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cf6/12240608/de7217dd9f33/cureus-0017-00000085650-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cf6/12240608/552c39154186/cureus-0017-00000085650-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cf6/12240608/bd1f3648002c/cureus-0017-00000085650-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cf6/12240608/17d7bdae2ee6/cureus-0017-00000085650-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cf6/12240608/de7217dd9f33/cureus-0017-00000085650-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cf6/12240608/552c39154186/cureus-0017-00000085650-i04.jpg

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本文引用的文献

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Retrograde Parent Artery Occlusion for Ruptured Intracranial Vertebral Artery Dissecting Aneurysms Involving the Posterior Inferior Cerebellar Artery: The "Breakwater" Technique.用于累及小脑后下动脉的破裂性颅内椎动脉夹层动脉瘤的逆行 parent 动脉闭塞术：“防波堤”技术
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