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Abstract:

Aim: was to evaluate efficiency of stents-grafts in treatment of cerebral aneurysms.

Materials and methods: for the period of 2001-2012 implantation of stent-grafts was performedm 10 patients with cerebral aneurysms. Indications for implantation: huge or giant aneurysms; wide«neck» of aneurysm; difficult localization for neurosurgical techniques; absence of significant tortuosity of artery that could interfere successful stent delivery All patients underwent examination:

MSCT-angiography, MRI, cerebral angiography To predict possible stent thrombosis we performed angiographic tests with pinching of pathological artery and contrasting of opposite artery Then we assessed blood-flow of anterior and posterior communicating arteries and also changes in neurological status. Unsatisfactory condition of collateral blood-flow - was not a contraindication for stenting. In 8 patient, aneurysms were localized in internal carotid artery, and in 2 patients in the vertebrobasilar artery In 3 cases implantation of stent-graft was proceeded in acute period of hemorrhage; that caused late disaggregant therapy (immediately after implantation, drugs were injected through nasogastric tube instead of 4-5 days of preoperative treatment).

Results: exclusion of the aneurysm from the blood-flow was reached 100% of cases. In one case, implantation of micro-coils was necessary due to inability to cover the whole neck of the aneurysm because of tortuosity of artery In 1 case we had thrombosis of stent in vertebral artery with spreading of thrombosis on basilar artery with development of ischemic stroke and further death.

Conclusion: use of stent-grafts for exclusion of huge and giant aneurysms from cerebral blood- flow is a highly effective method.

 

References

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