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J Neurol Surg A Cent Eur Neurosurg 2015; 76(05): 424-430
DOI: 10.1055/s-0035-1547356
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Curative Reconstruction of Giant Fusiform Intracranial Aneurysms with Flow-Diverter and Self-expanding Stents

Simone Peschillo
1   Department of Neurology and Psychiatry, Endovascular Neurosurgery/Interventional Neuroradiology, ‘Sapienza’ University of Rome, Rome, Italy
,
Edoardo Boccardi
2   Department of Neuroradiology, Ospedale Niguarda-Ca' Granda, Milan, Italy
,
Delia Cannizzaro
3   Division of Neurosurgery, Department of Neurology and Psychiatry, University of Rome: Sapienza, Rome, Italy
,
Giulio Guidetti
4   Interventional Neuroradiology, Department of Neurology and Psychiatry, University of Rome: Sapienza, Rome, Italy
,
Luca Valvassori
2   Department of Neuroradiology, Ospedale Niguarda-Ca' Granda, Milan, Italy
,
Roberto Delfini
4   Interventional Neuroradiology, Department of Neurology and Psychiatry, University of Rome: Sapienza, Rome, Italy
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Publikationsverlauf

29. Juni 2013

30. Dezember 2014

Publikationsdatum:
27. April 2015 (online)

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Abstract

Objective and Importance To demonstrate the curative reconstruction of two giant fusiform aneurysms using a combination of flow-diverter stents and self-expanding stents for intracranial use.

Clinical Presentation Two cases that would have been difficult to manage with standard methods: one patient with deficiencies of cranial nerves VI and VII on the left, acute diplopia, and an aneurysm of the vertebrobasilar bifurcation, the other with diplopia, deficiencies of cranial nerves III and VI, and an aneurysm of the intracavernous internal carotid artery.

Intervention or Technique Complete reconstruction was achieved using a combination of flow-diverter and self-expandable stents. Follow-up investigations at 6 months demonstrated the complete reconstruction of the arteries and angiographically determined disappearance of the aneurysms with resolution of the clinical profile. The patients' outcome was excellent (modified Rankin Scale: 0).

Conclusion This technique enables safe and definitive treatment of lesions that would be difficult to manage with other methods. The greater metal surface does not seem to interfere with the perforating arteries originating from the segments involved.

Keywords

flow-diverter stent - fusiform aneurysm - giant aneurysm - endovascular treatment - endovascular neurosurgery - intracranial stent
 

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