Successful endovascular treatment of a growing megadolichoectasic vertebrobasilar artery aneurysm by flow diversion using the "diverter-in-stent" technique
Successful endovascular treatment of a growing megadolichoectasic vertebrobasilar artery aneurysm by flow diversion using the "diverter-in-stent" technique
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DOI：
10.1016/j.jocn.2011.07.011
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发表时间：
2012-01-01
影响因子：
2
通讯作者：
Itshayek, Eyal
中科院分区：
文献类型：
--
作者：
Cohen, Jose E.;Gomori, John M.;Itshayek, Eyal
椎基底动脉巨大的膨大和梭状动脉瘤是最难和最危险的动脉瘤之一。对于无症状的老年患者，保守治疗可能是合理的。然而，由于脑干经常存在肿块效应，并且存在血栓栓塞事件和破裂的风险，这些动脉瘤通常需要治疗而不是观察。随着血管内技术的进步，这些病变中的一些已经可以治疗，而没有与开放手术治疗相关的高发病率和死亡率。当处理巨大的、逐渐增大的有症状的动脉瘤时，可用的治疗方法比较有限。作者提出了一个病例的增长大血管扩张椎基底动脉动脉瘤造成主要残疾，由于增加的质量效应在一个51岁的男子。动脉瘤通过放置多个伸缩支架和分流器（“支架内分流器”技术）进行分流治疗，实现了动脉瘤血栓形成，减少了脑干的肿块效应，神经系统得到改善。在我们的病例中，成功的临床和血管造影结果为通过血流转移治疗巨大动脉瘤提供了文献。(C) 2011 Elsevier Ltd.版权所有。
Giant dolichoectatic and fusiform aneurysms of the vertebrobasilar artery are among the most difficult and dangerous aneurysms to treat. Conservative management may be reasonable in asymptomatic elderly patients. Nevertheless, due to the frequent presence of mass effect on the brainstem and the risks of thromboembolic events and rupture, these aneurysms often demand treatment rather than observation. With the advancement of endovascular techniques some of these lesions have become treatable without the high morbidity and mortality rates associated with open surgical treatment. When dealing with giant, progressively enlarging symptomatic aneurysms, more limited therapeutic alternatives are available. The authors present a case of a growing megadolichoectatic vertebrobasilar artery aneurysm causing major disability due to increasing mass effect in a 51-year-old man. The aneurysm was treated with flow diversion by placing multiple telescoped stents and diverters ("diverter-in-stent" technique), achieving thrombosis of the aneurysm and reduction of the mass effect on the brainstem, with neurological improvement. The successful clinical and angiographic results observed in our case of giant dolichoectasic vertebrobasilar aneurysm contribute to the literature on giant aneurysms treated by means of flow diversion. (C) 2011 Elsevier Ltd. All rights reserved.