Clinical Research Article
The clinical application study of individualized endovascular interventional treatment for C1 segment of internal carotid artery aneurysms
Li Tengfei, Shi Chengcheng, Yu Sun, Ma Ji, Wang Ling, Song Yan, Han Xinwei
Published 2021-11-30
Cite as Chin J Vasc Surg, 2021, 06(4): 250-255. DOI: 10.3760/cma.j.cn101411-20210725-00056
Abstract
ObjectiveTo evaluate the efficacy and safety of individualized endovascular interventional treatment for C1 segment of internal carotid artery (ICA) aneurysms and to explore its clinical application value.
MethodsA retrospective analysis on clinical data of 47 patients with C1 segment of ICA aneurysms who had undergone endovascular interventional therapy in the First Affiliated Hospital of Zhengzhou University from August 2015 to February 2021, including 41 cases of true aneurysm, 6 cases of dissecting aneurysm and 3 cases of pseudoaneurysm. Depending on the character, size and morphology of the aneurysms as well as the diameter and tortuosity of the parent arteries, endovascular interventional treatment (e.g., simple coil embolization, overlapping or single woven stent placement, covered stent placement, and flow-diverter stent placement) was custom-designed for each patient. According to the immediate postoperative digital subtraction angiography (DSA) and follow-up results of DSA after 6 months, the degree of aneurysm occlusion and effectiveness of this therapy were assessed. The adverse events during the perioperative period were observed and recorded.
ResultsThe surgical treatment was successful in all 47 patients. The technical success rate was 100%. Of them, 28 patients were implanted with overlapping woven stents, 6 cases were treated with single woven stents, 6 cases were implanted with national flow-diverter stent, 3 cases were treated with simple coil embolization of aneurysms, 3 cases were treated with peripheral covered stent graft, and 1 case was treated with coil occlusion of the parent artery. Immediate postoperative DSA showed complete occlusion of the aneurysm or significant retention of contrast agent, and fluent blood flow of the parent artery. No serious complications such as aneurysm rupture or acute stent thrombosis were observed during the perioperative period. During (12.1±4.4) months follow-up after operation, DSA or CTA at the 6 months follow-up after operation showed that 2 patients had mild in-stent stenosis and 1 patient had complete parent artery occlusion, while the remaining patients all revealed smooth parent artery blood flow, complete aneurysm occlusion, and no obvious in-stent stenosis.
ConclusionIndividualized endovascular interventional treatment is a safe and effective therapy for C1-segment of ICA aneurysms.
Key words:
Aneurysm; Carotid artery; Interventional therapy; Stent
Contributor Information
Li Tengfei
Department of Radiology and Interventional Medicine, The First Affiliated Hospital of Zhengzhou University, Institute of Interventional Therapy of Zhengzhou University, Zhengzhou 450052, China
Shi Chengcheng
Department of Radiology and Interventional Medicine, The First Affiliated Hospital of Zhengzhou University, Institute of Interventional Therapy of Zhengzhou University, Zhengzhou 450052, China
Yu Sun
Department of Radiology and Interventional Medicine, The First Affiliated Hospital of Zhengzhou University, Institute of Interventional Therapy of Zhengzhou University, Zhengzhou 450052, China
Ma Ji
Department of Radiology and Interventional Medicine, The First Affiliated Hospital of Zhengzhou University, Institute of Interventional Therapy of Zhengzhou University, Zhengzhou 450052, China
Wang Ling
Department of Radiology and Interventional Medicine, The First Affiliated Hospital of Zhengzhou University, Institute of Interventional Therapy of Zhengzhou University, Zhengzhou 450052, China
Song Yan
Department of Vascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Han Xinwei
Department of Radiology and Interventional Medicine, The First Affiliated Hospital of Zhengzhou University, Institute of Interventional Therapy of Zhengzhou University, Zhengzhou 450052, China
