Use of Distal Intracranial Catheters for Better Working View of Cerebral Aneurysms Hidden by Parent Artery or Its Branches: A Technical Note.

IF 1.2 Q4 CLINICAL NEUROLOGY Neurointervention Pub Date : 2021-11-01 Epub Date: 2021-10-07 DOI:10.5469/neuroint.2021.00269
Ehab Mahmoud, Samuel Lenell, Christoffer Nyberg, Ljubisa Borota
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Abstract

A good working view is critical for safe and successful endovascular treatment of cerebral aneurysms. In a few cases, endovascular treatment of cerebral aneurysms may be challenging due to difficulty in obtaining a proper working view. In this report of 6 cases, we described the advantage of using a distal intracranial catheter (DIC) to achieve better visualization of cerebral aneurysms hidden by a parent artery or its branches. Between September 2017 and January 2021, we treated 390 aneurysms with endovascular techniques. In 6 cases in which it was difficult to obtain a proper working view, the DIC was placed distally close to the aneurysm in order to remove the parent artery projection from the working view and obtain better visualization of the aneurysm. Clinical and procedural outcomes and complications were evaluated. The position of the DIC was above the internal carotid artery siphon in the 6 cases. All aneurysms were successfully embolized. Raymond-Roy class 1 occlusion was achieved in all 4 unruptured aneurysms, while the result was class 2 in the 2 ruptured aneurysms. Placement of the DIC was atraumatic without dissections or significant catheter-induced vasospasm in all patients. Transient dysphasia was seen in 2 cases and transient aphasia in 1. Using this technique, we have found it possible to better visualize the aneurysm sac or neck and thereby treat cases we otherwise would have considered untreatable.

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使用远端颅内导管对隐藏于主动脉或其分支的脑动脉瘤有更好的工作视野:技术说明。
良好的工作视野对安全、成功地进行脑动脉瘤腔内治疗至关重要。在少数情况下,由于难以获得适当的工作视图,脑动脉瘤的血管内治疗可能具有挑战性。在这6例病例的报告中,我们描述了使用远端颅内导管(DIC)的优势,以更好地显示隐藏在父动脉或其分支中的脑动脉瘤。2017年9月至2021年1月,我们使用血管内技术治疗了390例动脉瘤。在6例难以获得正确工作视图的病例中,DIC被放置在靠近动脉瘤的远端,以便从工作视图中去除载动脉投影,获得更好的动脉瘤可视化。评估临床和手术结果及并发症。6例DIC位于颈内动脉虹吸上方。所有动脉瘤均成功栓塞。4个未破裂动脉瘤均达到Raymond-Roy 1级闭塞,2个破裂动脉瘤为2级闭塞。在所有患者中,DIC的放置是无伤性的,没有出现剥离或明显的导管引起的血管痉挛。短暂性言语障碍2例,短暂性失语1例。使用这项技术,我们发现可以更好地观察动脉瘤囊或颈部,从而治疗我们认为无法治疗的病例。
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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
34
审稿时长
12 weeks
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