Management of vascular perforations that occur during neurointerventional procedures.

摘要: This article describes a number of treatment strategies for the management perforations that occur during neurointerventional procedures. During past 5 years, we have performed over 1200 endovascular procedures to treat vascular disorders involving brain and spinal cord (400 cerebral arteriovenous malformations, 230 tumors, 197 carotid cavernous fistulas, 183 aneurysms, 130 dural 80 18 vein Galen 20 cases vasospasm). Fifteen patients (1.1%) sustained perforation as direct result these Among 15 patients, indications were six symptomatic two sinus one transverse fistula, case vasospasm following subarachnoid hemorrhage, malformation, ruptured basilar artery aneurysm. The grouped into three probable mechanisms: mechanical normal vessel (six patients), disruption dysplastic or aneurysm (five fluid overinjection (four patients). Treatment included immediate reversal anticoagulants (12 patients) closure site with coils In addition, intravascular compartment adjacent was achieved liquid adhesives balloons (two particles detachable balloon placed transiently across several minutes, deflated, removed when no further extravasation noted. Five started on anticonvulsant therapy, whom had new onset seizure related perforation.(ABSTRACT TRUNCATED AT 250 WORDS)