Observation of Neointimal Coverage Around the Aneurysm Neck After Stent-Assisted Coil Embolization by Optical Frequency Domain Imaging: Technical Case Report
| Autor: | Rie Yako, Hiroyuki Matsumoto, Osamu Masuo, Naoyuki Nakao |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Aneurysm Optical frequencies medicine Humans cardiovascular diseases Embolization Aged Coil embolization medicine.diagnostic_test business.industry Angiography Digital Subtraction Stent Intracranial Aneurysm equipment and supplies medicine.disease Embolization Therapeutic Domain imaging Surgery Apposition surgical procedures operative Angiography Female Stents Neurology (clinical) Radiology business Neck 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Operative Neurosurgery. 13:285-292 |
| ISSN: | 2332-4260 2332-4252 |
| DOI: | 10.1093/ons/opw018 |
| Popis: | Background and importance Stent-assisted coil embolization has been established as a treatment option for wide-necked or complex aneurysms. However, concerns have been raised about the incidence of thromboembolic complications, which is higher for coil embolization without stent assistance. Long-term antiplatelet therapy is necessary to prevent acute or delayed ischemic events potentially associated with incomplete stent apposition after treatment with stent-assisted coil embolization. Optical frequency domain imaging (OFDI) provides excellent-resolution images of intraluminal structures, allowing evaluation of the outcomes of stent-assisted procedures in terms of stent apposition and neointimal coverage. We here describe the novel use of OFDI for the observation of intravascular tissue formation after stent-assisted coil embolization. Clinical presentation Two patients were treated with stent-assisted coil embolization for unruptured vertebral artery aneurysm. At the 1- or 2-yr follow-up visit, routine angiography followed by OFDI were performed to evaluate neointimal coverage of the stent strut and stent apposition to the vascular wall. OFDI enabled clear visualization of the vessel wall structures and demonstrated complete coverage of the stent struts as well as full stent wall apposition in 1 patient and incomplete coverage near the aneurism neck as well as mallaposition of some struts in the other patient. Conclusion OFDI represents a feasible modality for the evaluation of intracranial vasculature and the outcomes of stent-assisted coil embolization in terms of intimal healing of aneurysms, stent-vessel interactions, and neointimal coverage of the stent. Such information is helpful in determining the duration of antiplatelet therapy after stent-assisted coil embolization. |
| Databáze: | OpenAIRE |
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