采用血流导向装置治疗破裂泡状动脉瘤的围手术期管理
Periprocedural management of ruptured blister aneurysms treated with pipeline flow diversion.
作者信息
Hoffman Jessa E, Morel Brent, Wittenberg Blake, Kumpe David, Seinfeld Joshua, Folzenlogen Zach, Case David, Neumann Robert, Cava Luis, Breeze Robert, Wiley Laura, Roark Christopher
机构信息
Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, United States.
出版信息
Surg Neurol Int. 2024 Mar 8;15:73. doi: 10.25259/SNI_482_2023. eCollection 2024.
BACKGROUND
Blister aneurysms are high-risk intracranial vascular lesions. Definitive treatment of these lesions has been challenging. Severe disability or mortality rates are as high as 55% when these lesions are treated with open surgery. Recent data show that flow diversion is a safe and effective alternative treatment for blister aneurysms. Rerupture of the functionally unsecured lesion remains a concern as flow diversion does not immediately exclude the aneurysm from the circulation.
METHODS
A retrospective review was performed of any patients with ruptured blister aneurysms treated with a pipeline embolization device between 2010 and 2020 at the University of Colorado.
RESULTS
In this paper, we present the results of the intensive care management of ruptured intracranial blister aneurysms after flow-diverting stent placement.
CONCLUSION
Despite the need for dual antiplatelet therapy and the delayed occlusion of blister aneurysms treated with flow diversion, we did not find an increase in periprocedural complications.
背景
泡状动脉瘤是高风险的颅内血管病变。对这些病变进行确切治疗一直具有挑战性。当采用开放手术治疗这些病变时，严重残疾或死亡率高达55%。近期数据表明，血流导向是治疗泡状动脉瘤的一种安全有效的替代治疗方法。由于血流导向不能立即将动脉瘤排除在循环之外，功能上未完全闭塞的病变再次破裂仍是一个令人担忧的问题。
方法
对2010年至2020年期间在科罗拉多大学接受管道栓塞装置治疗的所有破裂泡状动脉瘤患者进行回顾性研究。
结果
在本文中，我们展示了血流导向支架置入术后破裂颅内泡状动脉瘤的重症监护管理结果。
结论
尽管需要双重抗血小板治疗以及血流导向治疗的泡状动脉瘤闭塞延迟，但我们并未发现围手术期并发症增加。
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