Endovascular treatment of visceral artery and renal aneurysms (VRAA) using a constant mesh density flow diverting stent

CVIR Endovascular

Hong Kuan Kok¹  Ronil V. Chandra²  Anthony Lamanna³  Dinesh Ranatunga³  Rajeev Ravi³  Julian Maingard⁴  Hamed Asadi⁵  Duncan Mark Brooks⁶  Michael J. Lee⁷ 

[1] Faculty of Health, School of Medicine, Deakin University, Waurn Ponds, Australia;Interventional Radiology Service, Department of Radiology, Northern Hospital, Melbourne, Australia;Interventional Neuroradiology Unit, Monash Imaging, Melbourne, Australia;Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia;Interventional Radiology Service, Department of Radiology, Austin Hospital, Heidelberg, 3084, Melbourne, Victoria, Australia;Interventional Radiology Service, Department of Radiology, Austin Hospital, Heidelberg, 3084, Melbourne, Victoria, Australia;Interventional Neuroradiology Service, Radiology Department, Austin Hospital, Melbourne, Australia;Faculty of Health, School of Medicine, Deakin University, Waurn Ponds, Australia;Interventional Radiology Service, Department of Radiology, Austin Hospital, Heidelberg, 3084, Melbourne, Victoria, Australia;Interventional Neuroradiology Service, Radiology Department, Austin Hospital, Melbourne, Australia;Faculty of Health, School of Medicine, Deakin University, Waurn Ponds, Australia;Interventional Neuroradiology Unit, Monash Imaging, Melbourne, Australia;Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia;Interventional Radiology Service, Department of Radiology, Austin Hospital, Heidelberg, 3084, Melbourne, Victoria, Australia;Interventional Neuroradiology Service, Radiology Department, Austin Hospital, Melbourne, Australia;Faculty of Health, School of Medicine, Deakin University, Waurn Ponds, Australia;Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia;Interventional Radiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland;Royal College of Surgeons in Ireland, Dublin, Ireland;

关键词: Visceral artery;    Aneurysm;    Hepatic artery;    Renal artery;    Surpass;    Flow diverting stent;    Endovascular;   

DOI  :  10.1186/s42155-019-0057-1

来源: Springer

【 摘 要 】

BackgroundFlow diverting stents have been used safely and effectively for the treatment of intracranial aneurysms, particularly for large and wide necked aneurysms that are not amenable to conventional endovascular treatment with coiling. The Surpass Streamline device (Stryker Neurovascular, MI, USA) is a relatively new and unique flow diverting stent which maintains constant device mesh density over varying vessel diameters. This may potentially provide advantages compared to other flow diverting stents in achieving aneurysmal occlusion.Case presentationTwo patients with VRAA were treated using the Surpass Streamline device. The first patient was a 65-year-old male with an incidental 2.4 cm aneurysm originating from the hepatic artery near the gastroduodenal artery (GDA). The second patient was a 56-year-old male with an incidental 1.9 cm renal aneurysm arising from an anterior inferior segmental branch of the left renal artery. A Surpass flow diverting stent was used to successfully exclude the aneurysm neck in both cases.Reduced flow was achieved in one patient (equivalent to O’Kelly-Marotta [OKM] Grade B1). Preserved flow and stagnation (equivalent to OKM Grade A3) was achieved in the other. There was preserved distal flow in the parent arteries. No immediate complications were encountered in either case. Complete occlusion of both aneurysms was seen on follow up CT angiographic imaging within 8-weeks.ConclusionsThe Surpass flow diverting stent can be used safely and effectively to treat VRAA. It should be considered in unruptured large and giant wide necked VRAAs aneurysms. Additional large prospective studies are required for further validation.

【 授权许可】

CC BY