- 期刊
A Pipeline Embolization Device In-Stent Thrombosis with Intra-Artery Therapy Procedure - A Case Report
使用派普萊栓塞裝置進行因支架內血栓形成之經動脈治療術－病例報告
摘要
Cerebral aneurysm and cerebral artery thrombosis are both devastating diseases. Traditional treatment of aneurysm includes Guglielmi detachable coils (GDC) embolization. Pipeline embolization device (PED) was first used in Linkou Chang Gung Memorial Hospital in 2012. Because of our mature skill, the treatment of aneurysm by PED was frequently manipulated after 2015. Acute cerebral thrombosis may cause ischemic stroke. At 2012 the only choice for thrombus treatment is injecting anticoagulant. From 2015 we could perform intra-arterial (IA) therapy. There are three techniques including IA thrombectomy, IA thrombolysis and angioplasty. This case suffered from aneurysm in communicating segment of left internal carotid artery (ICA). PED was selected to embolize the aneurysm successfully. However, acute in-stent thrombosis was highly suspected from magnetic resonance angiography (MRA). IA therapy was performed immediately and recanalized of left ICA. In-stent thrombosis may occur after the treatment of unruptured cerebral aneurysm by PED. IA therapy is suggested for recanalization when in-stent thrombosis is confirmed. Through introducing this case, the authors want to show that the novel neuro-intervention technique in Taiwan has been developed so far.
並列摘要
顱內動脈瘤與腦動脈栓塞皆是可能致命之疾病，傳統治療動脈瘤是使用古利艾美分離式線圈進行治療。2012年起林口長庚醫院開始使用派普萊栓塞裝置來治療動脈瘤，直到2015年因技術之成熟才開始大量使用此種治療方式。急性血栓產生會導致缺血性中風，2012年林口長庚醫院只能施打藥物來溶解血栓，2015年起開始執行經動脈治療術治療急性血栓；可分為三種方式：取栓、溶栓、血管成型術。此案例為左側內頸動脈交通段的動脈瘤，成功的採用派普萊栓塞裝置栓塞動脈瘤。然而手術後腦部核磁共振照影高度懷疑是急性血栓產生，再進行經動脈治療術後重新貫通左側內頸動脈。使用派普萊栓塞裝置治療未破裂之動脈瘤時有可能產生支架內血栓形成之副作用，若確診支架內血栓形成時可經動脈治療術來重新貫通血管。透過介紹此病例，作者想讓讀者了解目前台灣的腦神經介入治療醫療技術已發展至此。
延伸閱讀
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