ABSTRACT
Objective:To investigate the safety and efficacy of Tubridge flow diverter for the treatment of recurrent internal carotid blood blister-like aneurysms after stent-assisted embolization.Methods:From June 2018 to April 2021, patients with recurrent internal carotid blood blister-like aneurysms treated with Tubridge flow diverter in the Department of Neurosurgery, Changhai Hospital, Naval Medical University were enrolled retrospectively. The perioperative safety, immediate postoperative and follow-up results were analyzed.Results:A total of 6 patients with recurrent internal carotid blood blister-like aneurysm after stent-assisted embolization were enrolled. The time interval from the first stent-assisted embolization to Tubridge placement was 14 to 90 d. Tubridge implantation alone was used in 4 patients, and Tubridge was implanted in the other 2 patients after the coils were packed. There were no complications during the perioperative period, and no rebleeding was observed after clinical follow-up for 5 to 36 months. Five patients were followed up by angiography for 1-3 months, and the aneurysms disappeared completely.Conclusion:Tubridge flow diverter for the treatment of recurrent internal carotid blood blister-like aneurysms is safe and effective.
ABSTRACT
Intracranial aneurysm is a serious threat to human health, but the specific pathogenesis has not yet been identified. Circular RNA is a current research hotspot in non-coding RNA. It has a variety of biological functions and is widely involved in the regulation of gene expression in various diseases. This article focuses on the relationship between intracranial aneurysms and circular RNA, and investigates the potential effect of circular RNA on the pathogenesis of intracranial aneurysms.
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Objective To preliminarily analyze the risk factors for rupture of intracranial aneurysms combined with proximal parent artery stenosis. Methods From June 2016 to December 2018, 52 admitted patients with intracranial aneurysms combined with proximal parent artery atherosclerotic stenosis and admitted in Neurosurgery Department of First Hospital Affiliated to Naval Military Medical University were enrolled. All patients were diagnosed by DSA. The 52 patients were divided into the ruptured group and the unruptured group, with each group containing 26 patients. The baseline data, 3D DSA data, morphology and hemodynamic parameters of intracranial aneurysms with parent artery stenosis were collected and compared between the two groups. The baseline data included age, gender, prior history of hypertension, smoking, diabetes, cerebral infarction, oculomotor palsy and multiple aneurysms. 3 D DSA data included degree of stenosis (mild to severe). Morphological and hemodynamic parameters included normalized wall shear stress (NWSS), percentage of low wall shear stress area (LSA), aspect ratio (AR), distance of stenosis, size ratio (SR) and degree of stenosis (quantitative index). Results (1) The proportion of female in the ruptured group was higher than that in the unruptured group (80.8% [21/26] vs. 53. 8% [14/26] , χ2 =4. 282, P = 0. 039). There was no difference in ypertension, diabetes, smoking history, multiple aneurysms, cerebral infarction and oculomotor paralysis between the two groups (all P >0. 05). (2) There was no difference in the degree of stenosis (mild to severe) between the two groups (P > 0.05). (3) The ruptured group had lower NWSS than that of the unruptured group, but higher LSA and AR(0.691 [0. 560, 0. 867] vs. 0.852 [0.701, 1.097], Z = -2. 397; 7. 91% [1.28%, 11. 94%] vs. 1.36%[0.28%, 3.48%], Z = 2.581;[1. 1 ±0. 3] vs. [0. 9 ±0.4], t =2.751; all P 0. 05). Conclusion Female, high LSA, high AR and low NWSS may have an impact on the rupture of intracranial aneurysms with parent artery stenosis.
ABSTRACT
Objective To preliminarily investigate the safety and long-term efficacy of endovascular overlapping multi-stent angioplasty for the treatment of vertebral artery dolichoectasia.Methods From May 2009 to January 2011,the clinical and imaging data of 3 patients with vertebral artery dolichoectasia treated with overlapping multi-stent implantation at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were analyzed retrospectively.All 3 patients had prolongation and dilation on the left intracranial vertebral artery.One suffered compression of left medulla oblongata accompanied by old infarction of right thalamus,one complicated with ruptured aneurysm of left posterior cerebral artery received coil occlusion of the parent artery,and the other had a lacuna infarction on the left medulla oblongata with left intracranial vertebral artery dissection.Results 2-5 LEO stents were implanted into the left vertebral artery of each patient and the lesions were covered completely.The revascularization was successful in all patients and no perioperative complications occurred.The 3 patients were followed up for 5-8 years and no new clinical symptoms occurred.The modified Rankin scale score was 0.The DSA follow-up revealed that the vascular morphology of 2 cases was significantly improved compared with that before procedure.Conclusion The preliminary experience has shown that overlapping multi-stent angioplasty for the treatment of vertebral artery dolichoectasia is safe and the long-term effect of revascularization is satisfactory.