Endovascular isolation of intracranial blood blister-like aneurysms with Willis covered stent
Endovascular isolation of intracranial blood blister-like aneurysms with Willis covered stent
复制标题
Willis覆膜支架血管内隔离颅内血泡样动脉瘤
DOI：
10.1136/neurintsurg-2016-012662
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发表时间：
2017-10-01
影响因子：
4.8
通讯作者：
Teng, Fei
中科院分区：
文献类型：
--
作者：
Fang, Chun;Tan, Hua-Qiao;Teng, Fei
目的颅内血泡样动脉瘤(BBA)是一种少见的动脉壁全层缺失的动脉瘤。这些脆弱的动脉瘤在最小限度的操作下有破裂的倾向，这使得它们很危险，很难治疗。材料回顾分析13例经血管内支架治疗的BBA患者，男7例，女6例，年龄28~68岁。记录手术结果和治疗相关并发症。术后4~6个月进行血管造影和临床随访。结果所有患者均成功置入覆膜支架。即刻血管造影术显示12例动脉瘤完全闭塞，1例轻度内渗漏。较高的动脉瘤清除率保证了术后抗血小板治疗的安全性。眼动脉闭塞2例，脉络膜前动脉闭塞1例，均未出现急性或延迟性临床症状。血栓形成、动脉瘤破裂和其他并发症在任何情况下都没有发生。血管造影随访显示动脉瘤完全排出，无一例复发。只有2例患者出现无症状的轻中度支架内狭窄。所有患者均获得满意的临床结果(改良Rankin量表评分
Objective Intracranial blood blister-like aneurysm (BBA) is a rare type of aneurysm that lacks all layers of the arterial wall. These fragile aneurysms have the propensity to rupture with minimal manipulation, which makes them hazardous and difficult to treat. The present study evaluated the safety and feasibility of endovascular treatment of BBAs with the Willis covered stent.Materials Thirteen patients (7 men and 6 women, age range 28-68 years) who presented with ruptured BBAs and were treated with the Willis covered stent were retrospectively reviewed. Results of the procedures and treatment-related complications were recorded. Angiographic and clinical follow-ups were performed 4-6 months after the procedure.Results Placement of the covered stent was successful in all patients. Immediate angiography showed complete aneurysm occlusion in 12 patients while one patient showed a mild endoleak. This high rate of aneurysm exclusion ensured the security of postoperative antiplatelet treatment. Occlusion of the ophthalmic artery occurred in two patients and occlusion of the anterior choroidal artery occurred in one patient; however, none of them showed acute or delayed clinical symptoms. Thrombosis, aneurysm rupture, and other complications did not develop in any case. Angiographic follow-up showed complete aneurysm exclusion without aneurysm recurrence in any patients. Only two patients showed asymptomatic mild to moderate in-stent stenosis. All patients had satisfactory clinical outcomes (modified Rankin Scale score