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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Transvenous Coil Embolization for the Treatment of Carotid Cavernous Fistula after Pipeline Placement: A Case Report
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Transvenous Coil Embolization for the Treatment of Carotid Cavernous Fistula after Pipeline Placement: A Case Report

机译：吞咽肛门栓塞管道静脉栓塞管道放置后的吞咽螺旋栓塞：案例报告

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The Pipeline embolization device (PED), a type of flow diverter, has become an appealing alternative treatment option for large or giant and wide-necked intracranial aneurysms. Carotid cavernous fistula (CCF) resulting from delayed aneurysmal rupture is a rare complication of PED placement with unknown pathophysiology. Here, we describe a case of CCF resulting from aneurysmal rupture following PED placement, and present the details of treatment by transvenous coil embolization. An 81-year-old woman was referred to our hospital for treatment of an 18.0 x 10.3 mm intracranial aneurysm located in the cavernous segment of the left internal carotid artery, noted during an examination of her diplopia. Endovascular treatment was conducted by positioning a single PED (4.75 x 25 mm) across the neck of the aneurysm. The postoperative course was uneventful, and the patient was discharged 8 days post procedure. On post-procedure day 10, her left oculomotor nerve palsy had worsened and she had developed left abducens nerve palsy, left exophthalmos, and left chemosis. Angiography demonstrated left direct CCF because of rupture of the aneurysm that had been treated with PED. Transvenous coil embolization was performed on post-procedure day 11 to treat the CCF, and complete resolution of the CCF and significant thrombus formation within the aneurysm sac were confirmed 11 days after the second procedure. Our angiographic results suggest that the aneurysmal rupture was caused by aneurysmal volume expansion associated with PED-induced thrombosis. Transvenous coil embolization for the treatment of CCF following PED placement constitutes a new challenge.
机译：管道栓塞装置（PED）是一种流动分流器，已成为大型或巨大颅内动脉瘤的吸引人的替代治疗选择。延迟动脉瘤破裂引起的颈脉冲瘘（CCF）是具有未知病理生理学的PED放置的罕见并发症。这里，我们描述了在PED放置后的动脉瘤破裂引起的CCF的情况，并呈现通过吞咽卷轴栓塞治疗的细节。一名81岁的女性被称为我们的医院，用于治疗位于左内部颈动脉的海绵状片段的18.0×10.3mm的颅内动脉瘤，在她的复视期间注意到。通过将单个PED（4.75×25mm）定位穿过动脉瘤的颈部的单个PED（4.75×25mm）进行血管内处理。术后课程是不平行的，患者出院8天后术后。在术后第10天，她的左动眼球神经麻痹已经恶化，她已经发育了剩下的Abducens神经麻痹，左侧滴眼症和左切化。由于用PED处理的动脉瘤破裂，血管造影证明了左直接CCF。在术后第11天进行吞咽螺旋栓塞治疗CCF，并在第二种程序后11天确认了在动脉瘤SAC中的CCF和显着血栓形成的完整分辨率。我们的血管造影结果表明动脉瘤破裂是由与血栓形成相关的动脉瘤体积膨胀引起的。在PED放置后处理CCF的吞咽线圈栓塞构成了新的挑战。

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