前交通动脉瘤是最常见的颅内动脉瘤,破裂的风险很高,可导致发病率和死亡率。传统上,颅内动脉瘤通过神经外科手术入路夹闭治疗。然而,某些患者可能更喜欢侵入性较小的方法或不代表开放手术候选人。分流器,包括改流腔内装置(FRED),是通过经股动脉或桡动脉入路血管内放置的新一代支架。最近的研究表明,FRED既安全又有效,超过90%的患者完全闭塞动脉瘤。这个案例突出了一个有趣的后分流循环重塑现象,在那里,分流器治疗可以改变Willis解剖学和生理学的循环。
Anterior communicating artery aneurysms are the most common intracranial aneurysm and have a high risk of rupture which can lead to morbidity and mortality. Traditionally, intracranial aneurysms were treated by clipping with neurosurgical access. However, certain patients may prefer less invasive approaches or not represent open surgical candidates. Flow diverters, including flow-redirection endoluminal devices (FRED), are new-generation stents that are placed endovascularly by transfemoral or transradial access. Recent studies have demonstrated that FRED is both safe and effective, with complete occlusion of aneurysms in over 90% of patients. This
case highlights an interesting phenomenon of post-flow diversion circulatory remodeling, where flow diverter treatment can alter the circle of Willis anatomy and physiology.