Background:Endovascular coiling for wide-neck aneurysms with a branch arising from the aneurysmal sac is challenging and sometimes considered impossible.This study aims to present our experience in treating wide-neck ...Background:Endovascular coiling for wide-neck aneurysms with a branch arising from the aneurysmal sac is challenging and sometimes considered impossible.This study aims to present our experience in treating wide-neck internal carotid artery(ICA)aneurysms with a posterior communicating artery(PComA)arising from the sac using a strategy of stenting the ICA and intentional compartmentalization to preserve the flow in the PComA.Methods:Eight consecutive cases of wide-neck ICA aneurysms with a fetal-type PComA arising from the aneurysmal sac were embolized from January 2015 to June 2018 at the First Affiliated Hospital,College of Medicine,Zhejiang University.Demographics,angiographic technique,procedural complications and clinical outcomes were reviewed.Results:There were 2 men and 6 women ranging from 56 to 81 years of age.Of the 8 cases,3 were ruptured and 5 were unruptured aneurysms.Stents were successfully deployed in all 8 cases.Near-complete occlusion was achieved in 3 cases(37.5%),neck remnant in 4(50%)and sac remnant in one(12.5%)of the cases.One case suffered transient ischemic attack after procedure completion.The clinical outcome was favorable in all 8 cases(modified Rankin scale 0-1).No rebleeding occurred during clinical follow-up.Conclusion:Stent-assisted compartmentalized embolization is feasible and safe in the treatment of wide-neck ICA aneurysm with a PComA arising from the sac.展开更多
基金supported by the grant from the Zhejiang Province Scientific Fund(LY12F02035).
文摘Background:Endovascular coiling for wide-neck aneurysms with a branch arising from the aneurysmal sac is challenging and sometimes considered impossible.This study aims to present our experience in treating wide-neck internal carotid artery(ICA)aneurysms with a posterior communicating artery(PComA)arising from the sac using a strategy of stenting the ICA and intentional compartmentalization to preserve the flow in the PComA.Methods:Eight consecutive cases of wide-neck ICA aneurysms with a fetal-type PComA arising from the aneurysmal sac were embolized from January 2015 to June 2018 at the First Affiliated Hospital,College of Medicine,Zhejiang University.Demographics,angiographic technique,procedural complications and clinical outcomes were reviewed.Results:There were 2 men and 6 women ranging from 56 to 81 years of age.Of the 8 cases,3 were ruptured and 5 were unruptured aneurysms.Stents were successfully deployed in all 8 cases.Near-complete occlusion was achieved in 3 cases(37.5%),neck remnant in 4(50%)and sac remnant in one(12.5%)of the cases.One case suffered transient ischemic attack after procedure completion.The clinical outcome was favorable in all 8 cases(modified Rankin scale 0-1).No rebleeding occurred during clinical follow-up.Conclusion:Stent-assisted compartmentalized embolization is feasible and safe in the treatment of wide-neck ICA aneurysm with a PComA arising from the sac.
