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线圈通过两个流量转移支架进行迁移
Patrick Scott Rogers1, David Volders2, Gwynedd Pickett3
1Diagnostic Imaging, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada pt319294@dal.ca.
BMJ case reports
|January 18, 2024
概括
在复发性内动脉 (ICA) 囊泡动脉瘤的重新治疗期间发生了一种罕见的并发症. 通过重叠的流量转移支架进入中脑动脉的线圈迁移突出了神经干预手术中以前未知的风险.
科学领域:
- 神经外科 神经外科
- 干预性神经放射学 干预性神经放射学
- 血管神经学 血管神经学
背景情况:
- 由于上内动脉 (ICA) 囊动脉瘤导致的下结节出血 (SAH) 需要有效的治疗.
- 流量转移支架 (FD) 和卷轴是复杂动脉瘤的确立治疗方法.
- 复发需要仔细考虑再处理策略.
研究的目的:
- 在复发性ICA泡动脉瘤的神经干预治疗期间报告罕见的并发症.
- 为了突出通过重叠的流量转移器支架网的远程线圈迁移的潜力.
主要方法:
- 一名因破裂的ICA泡动脉瘤引起的SAH患者接受了FD和卷积的治疗.
- 用第二个FD来管理复发,并通过后循环访问尝试PCOM卷轴.
- 血管造影和神经干预技术用于诊断和治疗.
主要成果:
- 最初的治疗是成功的,但通过后部通讯动脉 (PCOM) 发生了大量复发.
- 在ICA中用第二个FD重新治疗并没有达到足够的动脉瘤静止.
- 在PCOM卷轴过程中,一个远端卷轴末端通过两个重叠的FD的网格迁移到中脑动脉中.
结论:
- 这一案例表明了之前未知的卷轴迁移并发症,通过在神经干预手术过程中重叠的FD.
- 流量转移器支架的组成可能会导致这种类型的并发症.
- 对于神经干预学家来说,意识到这种潜在问题至关重要.
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