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Abstract:

OBJECTIVE AND IMPORTANCE: An innovative stenting technique to treat a difficult case of a fusiform aneurysm of the intracranial vertebral artery (VA), with restoration of the vessel lumen, is described. CLINICAL PRESENTATION: A 58-year-old patient experienced sudden pain in the upper cervical spine, followed by a severe headache. He underwent computed tomographic evaluation, which demonstrated subarachnoid hemorrhage in the prepontine cistern. A fusiform aneurysm of the distal right VA and critical stenosis of the left VA were detected in digital subtraction angiograms. The patient experienced a new subarachnoid hemorrhaging episode, and urgent endovascular treatment was planned. INTERVENTION: The patient underwent angioplastic and stenting procedures in the left VA, with good results. Forty-eight hours later, an endovascular procedure was performed to treat the right VA aneurysm. We decided to use a graft stent (Jostent graft stent; Jomed, Conroe, TX) instead of a balloon to preserve the arterial lumen. The complete procedure was well tolerated by the patient, and he was discharged, without symptoms, 48 hours later. CONCLUSION: The patient was discharged, without neurological deficits, 48 hours after completion of the endovascular procedure, with clopidogrel (75 mg/d) and aspirin (325 mg/d) therapy. This treatment was discontinued after 4 weeks. According to our search of the medical literature, this is the first clinical case in which an intracranial fusiform aneurysm was permanently sealed with a graft stent.

Registro:

Documento: Artículo
Título:Intravascular graft stent treatment of a ruptured fusiform dissecting aneurysm of the intracranial vertebral artery: Technical case report
Autor:Chiaradio, J.C.; Guzman, L.; Padilla, L.; Chiaradio, M.P.
Filiación:Department of Neurosurgery, Buenos Aires Cardiovascular Institute, Buenos Aires, Argentina
Department of Interventional Cardiology, Buenos Aires Cardiovascular Institute, Buenos Aires, Argentina
Instituto Cardiovascular de Buenos Aires, Blanco Encalada 1543, 1428 Capital Federal, Buenos Aires, Argentina
Palabras clave:Endovascular treatment; Fusiform aneurysm; Graft stent; Intracranial; Subarachnoid hemorrhage; adult; angioplasty; artery occlusion; article; blood vessel graft; case report; clinical feature; computer assisted tomography; diagnostic imaging; digital subtraction angiography; dissecting aneurysm; human; male; priority journal; stent; subarachnoid hemorrhage; vertebral artery; aneurysm rupture; artery dissection; brain angiography; middle aged; percutaneous transluminal angioplasty; radiography; retreatment; stent; subarachnoid hemorrhage; treatment outcome; vertebrobasilar insufficiency; Aneurysm, Ruptured; Angioplasty, Balloon; Cerebral Angiography; Humans; Male; Middle Aged; Retreatment; Stents; Subarachnoid Hemorrhage; Tomography, X-Ray Computed; Treatment Outcome; Vertebral Artery Dissection; Vertebrobasilar Insufficiency
Año:2002
Volumen:50
Número:1
Página de inicio:213
Página de fin:217
DOI: http://dx.doi.org/10.1097/00006123-200201000-00034
Título revista:Neurosurgery
Título revista abreviado:Neurosurgery
ISSN:0148396X
CODEN:NRSRD
Registro:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_0148396X_v50_n1_p213_Chiaradio

Referencias:

  • Chou, S.N., Ortiz-Suarez, H.J., Surgical treatment of arterial aneurysms of the vertebrobasilar circulation (1974) J Neurosurg, 41, pp. 671-680
  • Grand, W., Budny, J., Gibbons, K., Sternau, L., Hopkins, N., Microvascular surgical anatomy of the vertebrobasilar junction (1997) Neurosurgery, 40, pp. 1219-1225
  • note; Higashida, R.T., Smith, W., Gress, D., Urwin, R., Dowd, C.F., Balousek, P.A., Halbach, W., Intravascular stent and endovascular coil placement for a ruptured fusiform aneurysm of the basilar artery: Case report and review of the literature (1997) J Neurosurg, 87, pp. 944-949
  • Lanzino, G., Wakhloo, A., Fessler, R., Hartney, M., Guterman, L., Hopkins, N., Efficacy and current limitations of intravascular stents for intracranial internal carotid, vertebral and basilar artery aneurysm (1999) J Neurosurg, 91, pp. 538-546
  • Logue, V., Posterior fossa aneurysms (1964) Clin Neurosurg, 11, pp. 183-207
  • Lownie, S.P., Pelz, D.M., Fox, A.J., Endovascular therapy of a large vertebral aneurysm using stent and coils (2000) Can J Neurol Sci, 27, pp. 162-165
  • Lylyk, P., Ceratto, R., Hurvitz, D., Basso, A., Treatment of a vertebral dissecting aneurysm with stents and coils: Technical case report (1998) Neurosurgery, 43, pp. 385-388
  • Massoud, T.F., Turjman, F., Ji, C., Viñuela, F., Guglielmi, G., Gobin, Y.P., Duckwiler, G.R., Endovascular treatment of fusiform aneurysms with stents and coils: Technical feasibility in a swine model (1995) AJNR Am J Neuroradiol, 16, pp. 1953-1963
  • Mizutani, T., Miki, Y., Kojima, H., Suzuki, H., Proposed classification of nonatherosclerotic cerebral fusiform and dissecting aneurysms (1999) Neurosurgery, 45, pp. 253-259
  • note; Parodi, J.C., Endovascular repair of abdominal aortic aneurysms and other arterial lesions (1995) J Vasc Surg, 21, pp. 549-557
  • Parodi, J.C., Palmaz, J.C., Barone, H.D., Transfemoral intraluminal graft implantation for abdominal aortic aneurysm (1991) Ann Vasc Surg, 5, pp. 491-499
  • Sekhon, L., Morgan, M., Sorby, W., Grinnell, V., Combined endovascular stent implantation and endosaccular coil placement for the treatment of a wide-necked vertebral artery aneurysm: Technical case report (1998) Neurosurgery, 43, pp. 380-383
  • Sigwart, U., Puel, J., Mirkovitch, V., Joffre, F., Kappenberger, L., Intravascular stents to prevent occlusion and restenosis after transluminal angioplasty (1987) N Engl J Med, 316, pp. 701-706
  • Troupp, H., The natural history of aneurysms of the basilar bifurcation (1971) Acta Neurol Scand, 47, pp. 350-356
  • Wakhloo, A.K., Lanzino, G., Lieber, B.B., Hopkins, L.N., Stents for intracranial aneurysms: The beginning of a new endovascular era? (1998) Neurosurgery, 43, pp. 377-379
  • Wakhloo, A.K., Tio, F.O., Lieber, B.B., Schellhammer, F., Graf, M., Hopkins, L.N., Self-expanding nitinol stents in canine vertebral arteries: Hemodynamics and tissue response (1995) AJNR Am J Neuroradiol, 16, pp. 1043-1051

Citas:

---------- APA ----------
Chiaradio, J.C., Guzman, L., Padilla, L. & Chiaradio, M.P. (2002) . Intravascular graft stent treatment of a ruptured fusiform dissecting aneurysm of the intracranial vertebral artery: Technical case report. Neurosurgery, 50(1), 213-217.
http://dx.doi.org/10.1097/00006123-200201000-00034
---------- CHICAGO ----------
Chiaradio, J.C., Guzman, L., Padilla, L., Chiaradio, M.P. "Intravascular graft stent treatment of a ruptured fusiform dissecting aneurysm of the intracranial vertebral artery: Technical case report" . Neurosurgery 50, no. 1 (2002) : 213-217.
http://dx.doi.org/10.1097/00006123-200201000-00034
---------- MLA ----------
Chiaradio, J.C., Guzman, L., Padilla, L., Chiaradio, M.P. "Intravascular graft stent treatment of a ruptured fusiform dissecting aneurysm of the intracranial vertebral artery: Technical case report" . Neurosurgery, vol. 50, no. 1, 2002, pp. 213-217.
http://dx.doi.org/10.1097/00006123-200201000-00034
---------- VANCOUVER ----------
Chiaradio, J.C., Guzman, L., Padilla, L., Chiaradio, M.P. Intravascular graft stent treatment of a ruptured fusiform dissecting aneurysm of the intracranial vertebral artery: Technical case report. Neurosurgery. 2002;50(1):213-217.
http://dx.doi.org/10.1097/00006123-200201000-00034