Standalone Flow Diversion Therapy Effectively Controls Rebleeding of Acutely Ruptured Internal Carotid Artery Trunk (Nonbranching) Microaneurysms

Autor:	José E. Cohen, Gustavo Rajz, Ronen R. Leker, Hans Henkes, John M. Gomori
Rok vydání:	2021
Předmět:	Brain aneurysm medicine.medical_specialty Subarachnoid hemorrhage subarachnoid hemorrhage Fulminant internal carotid artery Article flow diverter stent Aneurysm medicine.artery Occlusion blister aneurysm medicine hemorrhagic stroke Microaneurysm business.industry General Medicine medicine.disease Surgery Pulmonary embolism microaneurysm Medicine Internal carotid artery brain aneurysm business
Zdroj:	Journal of Clinical Medicine Volume 10 Issue 22 Journal of Clinical Medicine, Vol 10, Iss 5249, p 5249 (2021)
ISSN:	2077-0383
Popis:	Flow diversion is a promising option in selected patients with acutely ruptured microaneurysms. In this article, we reviewed our experience. Patients with acute spontaneous subarachnoid hemorrhage (SAH) after rupture of a blister-like or saccular microaneurysm (≤2 mm maximal diameter) at a nonbranching ICA site treated from January 2016 to June 2019 using flow diversion as standalone therapy were included in this study. An EVD was usually placed preventively. Antiplatelet effects of pre-procedure DAPT were evaluated (target PRU, 80–160). After the intervention, DAPT was continued for ≥6 months, aspirin—indefinitely. Angiographic controls were obtained. Fifteen patients (12 female mean age, 46.4 years) with 15 ruptured ICA microaneurysms (mean diameter, 1.8 mm) were included. An EVD was placed in 12 patients (75%) before DAPT administration and stenting. PRU values immediately before FDS were 1–134 (mean, 72.1). One patient died 27 days after flow diversion due to a suspected fulminant pulmonary embolism. Aneurysms were completely occluded at the 6–12-month angiographic follow-up in 14/14 surviving patients, with no rebleeding at a mean of 14 months. Late mRS was 0–2 in 13/14 patients and 3 in one due to sequelae of the original hemorrhage. Flow diversion provided robust aneurysm rebleeding control. Angiographic follow-up confirmed complete aneurysm occlusion in all the cases.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::505c40d604651acefb577c7602c10273 https://pubmed.ncbi.nlm.nih.gov/34830535 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.