Delayed In-Stent Occlusion Due to Stent-Related Changes in Vascular Geometry After Cerebral Aneurysm Treatment-Case Report
Delayed In-Stent Occlusion Due to Stent-Related Changes in Vascular Geometry After Cerebral Aneurysm Treatment-Case Report
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DOI：
10.2176/nmc.53.182
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发表时间：
2013-03-01
影响因子：
1.9
通讯作者：
Terada, Tomoaki
中科院分区：
文献类型：
--
作者：
Kono, Kenichi;Shintani, Aki;Terada, Tomoaki
支架辅助弹簧圈栓塞术作为治疗宽颈或复杂脑动脉瘤的一种选择最近已被接受。支架内延迟闭塞是由于支架相关的血管几何结构改变所致。一位66岁男性患者接受了支架辅助弹簧圈栓塞术治疗未破裂的椎动脉动脉瘤。使用Enterprise支架成功地进行了治疗。术后6个月随访，支架内无症状性闭塞。血管几何的三维分析显示，由于支架的放置，左侧椎动脉拉直了40度。这种对血管的拉直可能导致了血管的扭结和闭塞。支架相关血管几何形状的改变可能会导致血管扭曲，并导致脑动脉瘤治疗后的闭塞。前处理策略可能会避免这种风险。
Stent-assisted coil embolization has been recently accepted as a treatment option for wide-neck or complex cerebral aneurysms. Delayed in-stent occlusion is described due to stent-related changes in vascular geometry. A 66-year-old man underwent stent-assisted coil embolization for an unruptured aneurysm of the vertebral artery. The treatment was successfully performed using the Enterprise stent. Follow-up angiography at 6 months showed asymptomatic in-stent occlusion. Three-dimensional analysis of the vascular geometry revealed that the left vertebral artery was straightened by 40 degrees due to the stent placement. Such straightening of the vessel presumably caused kinking and occlusion of the vessel. Stent-related changes in vascular geometry may cause kinking of a vessel and result in occlusion after the treatment of cerebral aneurysms. Pre-treatment strategy may avoid this risk.