PDF(Pubmed)
Abstract：
UNASSIGNED: Spinal aneurysms rarely occur in the collateral circulation of the vertebral artery (VA). These aneurysms are difficult to treat. A flow diverter (FD) can be a therapeutic option.
METHODS: A 62-year-old man suffered subarachnoid hemorrhage. His Hunt-Hess scale classification was grade II. Digital subtraction angiography (DSA) revealed that the bilateral distal VAs were occluded, there were two flow-related aneurysms in the collateral circulation of the first radicular artery of the VA, and there was a dissecting aneurysm at the origin of the posterior inferior cerebellar artery (PICA). The FD covered the PICA dissecting aneurysm, and the first radicular artery originated in the VA. Postoperatively, computed tomography angiography revealed a patent PICA and regression of the aneurysm in the collateral circulation. At the one-month follow-up, he showed good recovery and was therefore allowed to return to work. Follow-up DSA confirmed the regression of the aneurysms. However, the intracranial VA and PICA were unexpectedly occluded.
UNASSIGNED: It is difficult to catheterize aneurysms in the collateral circulation to perform coiling. It is also dangerous to embolize such aneurysms with a liquid embolic agent. After FD deployment to cover the origin of the parent artery, the hemodynamic stress of the aneurysm decreases, and the aneurysm can regress.
CONCLUSIONS: Aneurysms in the collateral circulation were not accessible. FD deployment in the parent artery to cover the origin of the feeding artery of the collateral circulation is feasible for treating such aneurysms.
METHODS: A 62-year-old man suffered subarachnoid hemorrhage. His Hunt-Hess scale classification was grade II. Digital subtraction angiography (DSA) revealed that the bilateral distal VAs were occluded, there were two flow-related aneurysms in the collateral circulation of the first radicular artery of the VA, and there was a dissecting aneurysm at the origin of the posterior inferior cerebellar artery (PICA). The FD covered the PICA dissecting aneurysm, and the first radicular artery originated in the VA. Postoperatively, computed tomography angiography revealed a patent PICA and regression of the aneurysm in the collateral circulation. At the one-month follow-up, he showed good recovery and was therefore allowed to return to work. Follow-up DSA confirmed the regression of the aneurysms. However, the intracranial VA and PICA were unexpectedly occluded.
UNASSIGNED: It is difficult to catheterize aneurysms in the collateral circulation to perform coiling. It is also dangerous to embolize such aneurysms with a liquid embolic agent. After FD deployment to cover the origin of the parent artery, the hemodynamic stress of the aneurysm decreases, and the aneurysm can regress.
CONCLUSIONS: Aneurysms in the collateral circulation were not accessible. FD deployment in the parent artery to cover the origin of the feeding artery of the collateral circulation is feasible for treating such aneurysms.
摘要：
■椎动脉（VA）的侧支循环中很少发生动脉瘤。这些动脉瘤难以治疗。分流器(FD)可以是治疗选择。
方法：一名62岁男性患有蛛网膜下腔出血。他的Hunt-Hess量表分类为II级。数字减影血管造影（DSA）显示双侧远端血管阻塞，在VA的第一个神经根动脉的侧支循环中有两个与流量相关的动脉瘤，小脑后下动脉（PICA）的起源有夹层动脉瘤。FD覆盖了PICA夹层动脉瘤，第一个神经根动脉起源于VA.术后,计算机断层扫描血管造影显示PICA专利,侧支循环动脉瘤消退.在为期一个月的随访中，他恢复得很好，因此被允许重返工作岗位。随访DSA证实了动脉瘤的消退。然而,颅内VA和PICA意外闭塞。
■很难在侧支循环中插入动脉瘤以进行盘绕。用液体栓塞剂栓塞这种动脉瘤也是危险的。展开FD以覆盖父动脉的起源后，动脉瘤的血流动力学应力降低,动脉瘤会消退.
结论：无法进入侧支循环中的动脉瘤。在父动脉中展开FD以覆盖侧支循环的供血动脉的起源对于治疗此类动脉瘤是可行的。
方法：一名62岁男性患有蛛网膜下腔出血。他的Hunt-Hess量表分类为II级。数字减影血管造影（DSA）显示双侧远端血管阻塞，在VA的第一个神经根动脉的侧支循环中有两个与流量相关的动脉瘤，小脑后下动脉（PICA）的起源有夹层动脉瘤。FD覆盖了PICA夹层动脉瘤，第一个神经根动脉起源于VA.术后,计算机断层扫描血管造影显示PICA专利,侧支循环动脉瘤消退.在为期一个月的随访中，他恢复得很好，因此被允许重返工作岗位。随访DSA证实了动脉瘤的消退。然而,颅内VA和PICA意外闭塞。
■很难在侧支循环中插入动脉瘤以进行盘绕。用液体栓塞剂栓塞这种动脉瘤也是危险的。展开FD以覆盖父动脉的起源后，动脉瘤的血流动力学应力降低,动脉瘤会消退.
结论：无法进入侧支循环中的动脉瘤。在父动脉中展开FD以覆盖侧支循环的供血动脉的起源对于治疗此类动脉瘤是可行的。
