Stent-assisted spring coil embolization of intracranial aneurysms

Stent-assisted is an important technique in interventional embolization procedures for intracranial aneurysms. With stent-assisted, it is possible to obtain good therapeutic results, increase the embolization ratio, prevent aneurysm recurrence, and promote healing of wide neck, tiny, and shuttle-shaped intracranial aneurysms that previously could not obtain dense embolization or even cannot be embolized. The stent plays the following roles: 1) protect the aneurysm-carrying artery, so that the spring ring can fill in the aneurysm well and prevent postoperative cerebral infarction caused by stenosis and occlusion of the aneurysm-carrying artery; 2) increase the embolization density of the aneurysm neck, due to the blockage of the stent, the spring ring can be plasticized in the aneurysm neck according to the morphology of the aneurysm-carrying artery, completely covering the aneurysm neck and promoting thrombosis and healing; 3) change the aneurysm-carrying artery 3.Change the morphology of the aneurysm-carrying artery to direct blood flow, reduce blood flow into the aneurysm, and promote healing; 4.Stimulate the growth of new endothelium of the vessel to promote the healing of the aneurysm. The use of stent-assisted requires preoperative antiplatelet drug preparation and continuous postoperative antiplatelet therapy. The most critical time is within two months of surgery, which is an important time for vascular endothelialization, and regular antiplatelet therapy can greatly reduce the possibility of in-stent thrombosis. The following is a typical example of stent-assisted spring-ring embolization. Female, 53 years old, with spontaneous subarachnoid hemorrhage and DSA suggestive of a posterior communicating wide carotid aneurysm. Embolization of the aneurysm required protection of both the internal carotid artery and the posterior communicating artery. A stent was implanted in the artery passing through the internal carotid artery and posterior communicating artery to protect the aneurysm-carrying vessel, and the aneurysm was completely embolized with a microspring coil. Figure Typical case of stent-assisted embolization of posterior communicating aneurysm A: before embolization, An is the aneurysm, PcomA is the posterior communicating artery, and ICA is the internal carotid artery; B: intraoperative surgical strategy, yellow and green are stents, purple are spring coils, and blue are microcatheters; C: after embolization, the aneurysm is completely densely embolized, and the posterior communicating artery and internal carotid artery are well preserved.