<strong>Background:</strong> The pure arterial malformation (PAM) lesion has been recently described as a vascular pathology characterized by the sole presence of coiled, sometimes ectatic, arterial loops....<strong>Background:</strong> The pure arterial malformation (PAM) lesion has been recently described as a vascular pathology characterized by the sole presence of coiled, sometimes ectatic, arterial loops. 2% of the fusiform aneurysms are located in the vertebral-posterior inferior cerebellar arteries. <strong>Case Presentation:</strong> A 60 years old female with subarachnoid hemorrhage was diagnosed with a fusiform aneurysm in the right PICA related with a PAM in the digital subtraction angiography (DSA). With a negative super-selective Wada test, the patient was treated with embolization of the two lesions and the PICA for being in the same arterial territory with adhesive embolic liquid under roadmap fluoroscopy technique. The patient had a satisfactory clinical evolution and no added neurological deficit, so she was discharged 3 days after the treatment. <strong>Conclusion:</strong> These two vascular lesions located in the same artery are very rare and more in the PICA territory. It is important to make the best decision to treat them because of the potential complications;that’s why the procedure was supported with super-selective Wada test and neuromonitoring of the PICA territory. The injection of the mixture of NBCA and Lipiodol<span style="white-space:nowrap;"><sup>®</sup></span> under roadmap fluoroscopy is very safe.展开更多
Background: Research on the etiology and pathophysiology of fusiform aneurysm has been impeded due to the inability to collect fusiform aneurysm specimens. We aim to resolve this through the development of a novel fus...Background: Research on the etiology and pathophysiology of fusiform aneurysm has been impeded due to the inability to collect fusiform aneurysm specimens. We aim to resolve this through the development of a novel fusiform aneurysm model in rabbits.Methods: Sixty New Zealand White rabbits were divided into ten groups (n = 6 per group): groups A, B, C, D, E and groups a, b, c, d, e. Elastase, at a concentration of 0, 0.5, 1, 2.5 and 5 U/μL respectively was administered to each rabbit to incubate their carotid arteries. Three weeks later, angiography, histomorphometry,immunohistochemistry and immunofluorescent were performed.Results: Heparin administration is indispensable. No thrombosis was observed in groups A, B, C, D and E, whereas,increased thromboembolism occurred in groups a, b, c, d and e. Based on the size and wall thickness of aneurysms specimens, 5 U/μL was the optimal concentration of elastase to induce fusiform aneurysms. At 5 U/μL, the intraluminal carotid diameter increased significantly from 2.50 ± 0.32 mm to 3.11 ± 0.55 mm (p < 0.01). The wall thickness significantly reduced from 176.0 ± 39.8 μm to 39.7 ± 14.6 μm (p < 0.01) post aneurysm induction. The histolopathological evaluation revealed the elastic lamina and the smooth muscle cell''''s lamina were markedly attenuated and the intimal endothelial lamina became thin or even absent.Conclusions: Our research demonstrates that intracranial fusiform aneurysm could be modeled in rabbit carotid artery adventitia incubation by porcine pancreatic elastase.展开更多
目的观察不同方式的血管旁路移植术加动脉瘤切除或孤立术治疗大脑中动脉分叉以远梭形动脉瘤的临床疗效。方法 2006年11月-2010年10月北京三博脑科医院采用血管旁路移植术治疗9例未破裂大脑中动脉分叉部以远梭形动脉瘤,其中8例为单发,1...目的观察不同方式的血管旁路移植术加动脉瘤切除或孤立术治疗大脑中动脉分叉以远梭形动脉瘤的临床疗效。方法 2006年11月-2010年10月北京三博脑科医院采用血管旁路移植术治疗9例未破裂大脑中动脉分叉部以远梭形动脉瘤,其中8例为单发,1例为多发。中型动脉瘤1例,大型2例,巨大型5例,蛇形1例。颅内局部血管旁路移植术7例,颅内-颅外血管旁路移植术2例,同时行动脉瘤切除或孤立术。结果①术后DSA和(或)CT血管成像(CTA)检查显示,9例动脉瘤均不显影;7例移植血管通畅,2例移植血管不通。血管不通的2例中,1例术后10个月CTA显示移植血管再通;1例术后17 d DSA显示移植血管不通,动脉瘤远端皮质由侧支血管代偿供血。②术后1例肌力轻度下降,出院前完全恢复;3例有短暂口周抽搐,1例发生静脉出血性梗死。出院时格拉斯哥预后评分(GOS)4分1例,5分8例。③9例获6个月至4.5年随访,GOS均为5分。结论脑血管旁路移植术尤其是颅内局部血管旁路移植术,是治疗大脑中动脉分叉部以远梭形动脉瘤的有效方法。展开更多
文摘<strong>Background:</strong> The pure arterial malformation (PAM) lesion has been recently described as a vascular pathology characterized by the sole presence of coiled, sometimes ectatic, arterial loops. 2% of the fusiform aneurysms are located in the vertebral-posterior inferior cerebellar arteries. <strong>Case Presentation:</strong> A 60 years old female with subarachnoid hemorrhage was diagnosed with a fusiform aneurysm in the right PICA related with a PAM in the digital subtraction angiography (DSA). With a negative super-selective Wada test, the patient was treated with embolization of the two lesions and the PICA for being in the same arterial territory with adhesive embolic liquid under roadmap fluoroscopy technique. The patient had a satisfactory clinical evolution and no added neurological deficit, so she was discharged 3 days after the treatment. <strong>Conclusion:</strong> These two vascular lesions located in the same artery are very rare and more in the PICA territory. It is important to make the best decision to treat them because of the potential complications;that’s why the procedure was supported with super-selective Wada test and neuromonitoring of the PICA territory. The injection of the mixture of NBCA and Lipiodol<span style="white-space:nowrap;"><sup>®</sup></span> under roadmap fluoroscopy is very safe.
文摘Background: Research on the etiology and pathophysiology of fusiform aneurysm has been impeded due to the inability to collect fusiform aneurysm specimens. We aim to resolve this through the development of a novel fusiform aneurysm model in rabbits.Methods: Sixty New Zealand White rabbits were divided into ten groups (n = 6 per group): groups A, B, C, D, E and groups a, b, c, d, e. Elastase, at a concentration of 0, 0.5, 1, 2.5 and 5 U/μL respectively was administered to each rabbit to incubate their carotid arteries. Three weeks later, angiography, histomorphometry,immunohistochemistry and immunofluorescent were performed.Results: Heparin administration is indispensable. No thrombosis was observed in groups A, B, C, D and E, whereas,increased thromboembolism occurred in groups a, b, c, d and e. Based on the size and wall thickness of aneurysms specimens, 5 U/μL was the optimal concentration of elastase to induce fusiform aneurysms. At 5 U/μL, the intraluminal carotid diameter increased significantly from 2.50 ± 0.32 mm to 3.11 ± 0.55 mm (p < 0.01). The wall thickness significantly reduced from 176.0 ± 39.8 μm to 39.7 ± 14.6 μm (p < 0.01) post aneurysm induction. The histolopathological evaluation revealed the elastic lamina and the smooth muscle cell''''s lamina were markedly attenuated and the intimal endothelial lamina became thin or even absent.Conclusions: Our research demonstrates that intracranial fusiform aneurysm could be modeled in rabbit carotid artery adventitia incubation by porcine pancreatic elastase.
文摘目的观察不同方式的血管旁路移植术加动脉瘤切除或孤立术治疗大脑中动脉分叉以远梭形动脉瘤的临床疗效。方法 2006年11月-2010年10月北京三博脑科医院采用血管旁路移植术治疗9例未破裂大脑中动脉分叉部以远梭形动脉瘤,其中8例为单发,1例为多发。中型动脉瘤1例,大型2例,巨大型5例,蛇形1例。颅内局部血管旁路移植术7例,颅内-颅外血管旁路移植术2例,同时行动脉瘤切除或孤立术。结果①术后DSA和(或)CT血管成像(CTA)检查显示,9例动脉瘤均不显影;7例移植血管通畅,2例移植血管不通。血管不通的2例中,1例术后10个月CTA显示移植血管再通;1例术后17 d DSA显示移植血管不通,动脉瘤远端皮质由侧支血管代偿供血。②术后1例肌力轻度下降,出院前完全恢复;3例有短暂口周抽搐,1例发生静脉出血性梗死。出院时格拉斯哥预后评分(GOS)4分1例,5分8例。③9例获6个月至4.5年随访,GOS均为5分。结论脑血管旁路移植术尤其是颅内局部血管旁路移植术,是治疗大脑中动脉分叉部以远梭形动脉瘤的有效方法。