Kết quả bước đầu can thiệp nội mạch điều trị phình động mạch não lớn và khổng lồ bằng STENT thay đổi dòng chảy tại bệnh viện Chợ Rẫy

Initial results of endovascular neurointervention using flow - diversion stent for treatment of large and giant intracranial aneurysms at Choray Hospital

SUMMARY

Objectives: Currently, interventional neuroradiology using coiling technique for embolization of intracranial aneurysms has been becoming a standard method, can be an alternative method for surgical clipping. However, for wide-necked, fusiform, dissecting and giant aneurysms, incomplete occlusion and recanalization were still main limitations for long-termed outcomes. The development of flow-diversion stents has been leading to the possibility of complete occlusion of aneurysms due to change of blood flow into aneurysms, resulting in thrombogenesis inside the aneurysms.

Subjects and methods: Interventional neuroradiology using flowdiversion stent performed at Department of Radiology, Choray Hospital, from 01/2015 to 06/2017, the technique as follows: digital subtraction angiography, inserting of mirocatheter over the aneurysm neck, deploying the flow-diversion stent over the aneurysm neck. The efficacy and safety were evaluated by variants: complete and partial occlusion rates, procedural success rate, clinical improvement, procedural complication.

Results: 24 cases of large and giant intracranial aneurysms treated with flow-diversion stents, technical success rate 21/24 (87.5%), 03 cases failed to be performed had to change to other treatment or follow-up, 01 case of abrupt death during follow-up.

Conclusion: Using flow – diversion stent is a new technique, may be effectively alternative method compared to conventional aneurysmal coiling, especially in treatment of large and giant intracranial aneurysms.

Key words: Large and giant intracranial aneurysms, flow – diversion stent, interventional neuroradiology