Endovascular Treatment Using Predominantly Stent-Assisted Coil Embolization and Antiplatelet and Anticoagulation Management of Ruptured Blood Blister-Like Aneurysms.
| العنوان: | Endovascular Treatment Using Predominantly Stent-Assisted Coil Embolization and Antiplatelet and Anticoagulation Management of Ruptured Blood Blister-Like Aneurysms. |
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| المؤلفون: | Meckel, S, Singh, T P, Undrén, P, Ramgren, Birgitta, Nilsson, O G, Phatouros, C, McAuliffe, W, Cronqvist, Mats |
| المصدر: | AJNR. American journal of neuroradiology. 32:764-771 |
| مصطلحات موضوعية: | Medicin och hälsovetenskap, Klinisk medicin, Radiologi och bildbehandling, Medical and Health Sciences, Clinical Medicine, Radiology, Nuclear Medicine and Medical Imaging |
| الوصف: | BACKGROUND AND PURPOSE: BBA is a rare type of intracranial aneurysm that is difficult to treat both surgically and endovascularly and is often associated with a high degree of morbidity/mortality. The aim of this study was to present clinical and angiographic results, as well as antiplatelet/anticoagulation regimens, of endovascular BBA treatment by using predominantly stent-assisted coil embolization. MATERIALS AND METHODS: Thirteen patients (men/women, 6/7; mean age, 49.3 years) with ruptured BBAs were included from 2 different institutions. Angiographic findings, treatment strategies, anticoagulation/antiplatelet protocols, and clinical (mRS) and angiographic outcome were retrospectively analyzed. RESULTS: Eleven BBAs were located in the supraclinoid ICA, and 2 on the basilar artery trunk. Nine of 13 were ≤3 mm in the largest diameter, and 8/13 showed early growth before treatment. Primary stent-assisted coiling was performed in 11/13 patients, double stents and PAO in 1 patient, each. Early complementary treatment was required in 3 patients, including PAO in 2. In stent-placement procedures, altered periprocedural antiplatelet (11/12) and postprocedural heparin (6/12) protocols were used without evidence of thromboembolic events. Two patients had early rehemorrhage, including 1 major fatal SAH. Twelve of 13 BBAs showed complete or progressive occlusion at late angiographic follow-up. Clinical midterm outcome was good (mRS scores, 0-2) in 12/13 patients. CONCLUSIONS: Stent-assisted coiling of ruptured BBAs is technically challenging but can be done with good midterm results. Reduced periprocedural and postprocedural antiplatelet/anticoagulation protocols may be used with a low reasonable risk of thromboembolic complications. However, regrowth/rerupture remains a problem underlining the importance of early angiographic follow-up and re-treatment, including PAO if necessary. |
| URL الوصول: | https://lup.lub.lu.se/record/1884374 http://www.ncbi.nlm.nih.gov/pubmed/21372169?dopt=Abstract http://dx.doi.org/10.3174/ajnr.A2392 |
| قاعدة البيانات: | SwePub |
| تدمد: | 1936959X |
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| DOI: | 10.3174/ajnr.A2392 |