Application of parallel stent placement in the treatment of unruptured vertebrobasilar fusiform aneurysms
| Autor: | Baomin Li, Xinfeng Liu, Hui-Min Feng, Jun Wang, Xiang-yu Cao, Sheng Li, Yongping Liang, Ai-li Ge |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Subarachnoid hemorrhage medicine.medical_treatment Infarction Fusiform Aneurysm Neurosurgical Procedures 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale medicine.artery Occlusion Humans Medicine cardiovascular diseases Vertebral Artery Aged business.industry Stent Intracranial Aneurysm General Medicine Middle Aged medicine.disease Surgery Stenosis Treatment Outcome Posterior inferior cerebellar artery Basilar Artery Stents Radiology business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of Neurosurgery. 126:45-51 |
| ISSN: | 1933-0693 0022-3085 |
| DOI: | 10.3171/2015.12.jns151716 |
| Popis: | OBJECTIVE Large vertebrobasilar fusiform aneurysms (VFAs) represent a small subset of intracranial aneurysms and are often among the most difficult to treat. Current surgical and endovascular techniques fail to achieve a complete or acceptable result because of complications, including late-onset basilar artery thrombosis and perforator infarction. The parallel-stent placement technique was established in the authors' department, and this study reports the application of this technique in the treatment of unruptured VFAs. METHODS Eight patients with 8 unruptured VFAs who underwent parallel stent placement between April 2011 and August 2012 were included. The diameters of the VFAs ranged from 7.9 to 14.0 mm, and the lengths from 27.5 to 54.4 mm. Of the 8 patients with unruptured VFAs, 3 received double or triple parallel stents and 5 patients received a series-connected stent with another 1 or 2 stents deployed parallel to them. Outcomes for these patients were tabulated, based on the modified Rankin Scale (mRS) score and angiographic results. RESULTS All of the 25 stents were successfully placed without any treatment-related complications. During follow-up, 5 patients had decreased mRS scores, 2 were unchanged, and 1 was increased for subarachnoid hemorrhage. Immediate and follow-up clinical outcome was completely or partially recovered in most patients. Follow-up angiograms revealed 2 aneurysms were reduced in size and 6 were unchanged after stent placement. No in-stent stenosis, occlusion of the posterior inferior cerebellar artery, or perforators jailed by the stent occurred in any of the aneurysms. CONCLUSIONS These results provide encouraging support for the parallel-stent placement technique, which can be envisaged as an alternative strategy against unruptured VFAs. However, testing in more patients is needed. |
| Databáze: | OpenAIRE |
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