Balloon-Assisted Stent Visualization: A Simple Technique for Precise Measurement of Previously Placed Stent Diameter.

Asian journal of neurosurgery Pub Date : 2024-02-26 eCollection Date: 2024-03-01 DOI:10.1055/s-0044-1779421
Manato Sakamoto, Shigeomi Yokoya, Hidesato Takezawa, Midori Ichihashi, Kengo Kishida, Hideki Oka
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Abstract

Stent-assisted coil embolization is effective for treating intracranial aneurysms, improving outcomes and reducing recurrence rates. However, accurately measuring the diameter of a previously placed stent during imaging can be challenging due to coil artifacts. This poses difficulties in determining the coil packing and size of additional stents needed during retreatment. In a reported case, the use of a balloon enabled precise assessment of stent deployment. A 50-year-old male with a history of basilar artery-left superior cerebellar artery aneurysm underwent coil embolization, direct clipping, and stent-assisted coil embolization (SAC) over a span of 14 years. However, the aneurysm showed reenlargement over time. To address the recurrence, a balloon was used to assess the previously placed Neuroform Atlas stent. Additional coils were inserted outside the stent, and a Low-profile Visualized Intraluminal Support Blue stent was added. Postoperatively, there were no new neurological issues, and a follow-up magnetic resonance imaging showed no ischemic lesions . Balloon-assisted stent visualization (BASV) may be a useful method in the retreatment of SAC. It has the potential to provide valuable information for treatment planning.

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球囊辅助支架可视化:精确测量先前放置的支架直径的简单技术。
支架辅助线圈栓塞术可有效治疗颅内动脉瘤,提高疗效并降低复发率。然而,由于线圈的伪影,在成像过程中精确测量先前放置的支架的直径可能具有挑战性。这给确定再治疗时所需的线圈填料和额外支架的大小带来了困难。在报告的一个病例中,使用球囊可以精确评估支架的部署情况。一名 50 岁的男性患者曾患基底动脉-左侧小脑上动脉动脉瘤,在长达 14 年的时间里接受了线圈栓塞、直接剪切和支架辅助线圈栓塞(SAC)治疗。然而,随着时间的推移,动脉瘤出现了再次增大。为了解决复发问题,医生使用球囊对之前放置的 Neuroform Atlas 支架进行了评估。在支架外插入了额外的线圈,并添加了低剖面可视化蓝色腔内支撑支架。术后没有出现新的神经问题,随访磁共振成像显示没有缺血性病变。球囊辅助支架显像(BASV)可能是再治疗 SAC 的有效方法。它有可能为治疗计划提供有价值的信息。
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