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中脑动脉缺血并发症在从内 Carotid 动脉扩展到 M1 段的流量转换器部署后

Eyup Baykara¹, Abdullah Topcu, Ozkan Celiker

¹Biruni University - Medicana International Istanbul Hospital, Department of Neurosurgery, İstanbul, Türkiye.

Turkish neurosurgery

|March 18, 2024

概括

对延伸到中脑动脉 (MCA) 的内动脉动脉瘤的流量转移装置 (FDD) 具有17.6%的缺血并发症风险. 只有当其他治疗方法失败时才考虑FDD,特别是在ICA终端附近的动脉瘤.

科学领域:

内血管神经外科手术血管内血管神经外科
脑血管疾病脑血管疾病
干预性神经放射学干预性神经放射学

背景情况:

流量转移装置 (FDD) 用于内动脉瘤.
部署到中脑动脉 (MCA) 段 (M1) 可能会增加风险.
了解来自静脉支架狭窄 (ISS) 或静脉支架血栓 (IST) 的缺血风险至关重要.

研究的目的:

评估与FDD在延伸到M1段的内动脉 (ICA) 中部署相关的缺血风险.
在这些情况下,评估静脉狭窄 (ISS) 和静脉血栓 (IST) 的发生率.

主要方法:

在2015年1月至2020年期间,对未破裂的ICA动脉瘤用FDD治疗的患者进行了回顾性分析.
纳入标准:FDD扩展到M1部门.
从一个单一的学术中心的前性维护数据库中收集的数据.

主要成果:

34名患有36个动脉瘤的患者有FDD延伸到M1.
四名患者 (11.7%) 经历了MCA和lenticulostriate区域缺血.
三名患者患有IST,一名患有严重的ISS,导致整体缺血并发症率为17.6%.

结论:

如果其他治疗方法不适合,FDD应该是远端ICA动脉瘤的最后手段 (子距离ICA终端或终端≤5毫米).
在远端ICA动脉瘤治疗期间,尽量减少FDD延伸到M1.
对于高阻塞率和在其他选择失败时防止破裂,FDD仍然有效.

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