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Revista de la Facultad de Medicina (México)

On-line version ISSN 2448-4865Print version ISSN 0026-1742

Abstract

RUFINO SAAVEDRA, Carlos et al. Endovascular reconstruction of intracranial aneurysm using a Pipeline® flow diversifier device. Rev. Fac. Med. (Méx.) [online]. 2019, vol.62, n.3, pp.20-26.  Epub Oct 16, 2020. ISSN 2448-4865.  https://doi.org/10.22201/fm.24484865e.2019.62.3.04.

Introduction:

Intracranial aneurysms are cerebral vascular anomalies with an approximate global prevalence of 2 to 3% and are the main cause of non-traumatic subarachnoid hemorrhage. Diagnosis and preventive treatment of this entity can considerably reduce morbidity and mortality. With the advent of new devices for cerebral endovascular therapy such as flow diverters, the patient now has the option of choosing a less invasive procedure, which does not require conventional surgery. This represents a significant reduction in the number of days of in hospital stay and recovery. The procedure has showed a high degree of security. The endovascular treatment for intracranial aneurysms has evolved substantially in the last two decades, and has become the treatment of choice.

Case report:

Case 1: A 62-year-old male was admitted in the hospital after a moderate cranioencephalic trauma with transient loss of conscious and a holocranial headache. A cerebral angiography was performed to rule out subarachnoid hemorrhage. The angiography showed an intracranial aneurysm. It was localized in left internal carotid-posterior communicating artery. The measures were of 4mm X 3mm with a 3mm neck. The treatment was performed with a pipeline flow-diverting device, as well as an angiographic control 3 months after the treatment with a satisfactory evolution.

Case 2: A 59-year-old female patient with facial hemiparesis and ipsilateral arm, that showed a gradual increase in intensity and duration. A magnetic resonance study protocol was initiated and an intracranial aneurysm was observed in the communicating segment of the right internal carotid artery. The diameter of the aneurysmal sac was of 15 mm and also, a contralateral of 8 mm. Placement of a flow-diverting device was programmed.

Conclusion:

The use of flow-diverting devices is an excellent alternative for the treatment of incidental intracranial aneurysms, with important cost-effectiveness advantages, surgical time, hospital stay and recovery reduction. In addition to having a recovery percentage of 95% in 5 years.

Keywords : Intracranial aneurysm; subarachnoid hemorrhage; flow diverter device.

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