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Case Sharing: Perfiller® Coil for Treatment of Ruptured Posterior Communicating Artery Aneurysm

Case Sharing: Perfiller® Coil for Treatment of Ruptured Posterior Communicating Artery Aneurysm

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Position: Ruptured Posterior Communicating Artery Aneurysm

Surgery: Perfiller® Expansible Coil Embolization

Features: Frame Stable, Dense Filling, Soft Coil Body

 

Patient Information

• Male, 69 years old

 

Pre-operative imaging

 

• DSA Result: DSA angiography showed an aneurysm in the posterior communicating segment. The size of the aneurysm was about 3.5mm×5.15 mm, and the width of the aneurysmal neck was about 2.7mm.

 

• Rupture of posterior communicating artery aneurysm with subarachnoid hemorrhage, secondary ventricular hemorrhage, and grade 3 hypertension.


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Procedure

• The micro-catheter was inserted to the M1 segment, and the guide wire was withdrawn. The micro-catheter smoothly entered into the aneurysm cavity. After it was placed successfully, TJWY Perfiller® 5mm×15 cm-3D coil was used as a frame coil.



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• The angiography showed that the ruptured aneurysm had almost no bleeding symptoms immediately. Then the aneurysm was filled with Perfiller®3 mm×8 cm-2D and 2 mm×6 cm-2D coils one after another, and finished with Perfiller®1.5 mm×2 cm-2D coils.


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After operation

The postoperative angiography showed that the aneurysm was densely embolized, no contrast agent was residual in the aneurysm, and the blood flow in the parent artery and branch vessels was unobstructed. The operation was successful.


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Lepu-Medical TJWY Perfiller® polymer expansible coils include a complex type (3D) and a helical type (2D). The polymer expansion when exposed to water, which can effectively increase the embolization density, and immediately achieve the effect of dense embolization. Moreover, the expansion of the polymer can effectively increase the stability of the coil, avoid the overall compression of the coil caused by the impact of blood flow, thereby providing longer-lasting protection for the aneurysmal neck, avoiding "dog ear signs", and effectively reducing the long-term recurrence rate.

 

Since a certain gap is added between the metal wires of the expansible coil, the metal occupying effect of the expansible coil of the same length is lower, the coil body is softer than the bare coil, and the use process is safer and more effective.

 

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After the polymer expands with water, it is smaller than the first-level diameter of the coil. Its use process is not limited by time. It will not squeeze the adjacent coil and the wall of the aneurysm. It will only expand to the place with gaps. It will not over-expand that will cause the rupture of aneurysm.

 


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The new push system makes the push rod transfer the force more accurately, and the push process is easier and smoother.


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As China’s first detachable expansible coil system, it is featured with stable and fast detachment method, which can effectively reduce the operation time. Especially in the treatment of aneurysm rupture, it can race against time and reduce the risk of patients. 


 

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References:

[1] Liu Donghui, Duan Pengpeng, E Yajun, et al. Analysis of refractory spasm of the tumor-bearing artery during interventional embolization of anterior communicating aneurysm[J]. Journal of Practical Radiology, 2018, 34(7): 1094-1097.

[2] LeivoS, Hernesniemi J, Luukkonen M, et al. Early surgery improves the cure of aneurysm— induced oculomotorpalsy [J]. Surg Neurol, 1996, 45: 430–434.

[3] Dimopoulos VG, Fountas KN, Fehes CH, et al. Literature review regarding the Methodology of assessing third nerve paresis associated with non—ruptured posterior communicating artery aneurysms [J]. Neumsurg Rev, 2005, 28: 256-260.

[4] Yang MQ, Wang S, Zhao YL, et al. Postoperative recovery from posterior communicating aneury smcomplicated by oculomotor palsy [J]. Chin Med J (En91), 2008,121: 1065-1067.

[5] Kawabata Y, Nakazawa T, Fukuda S. Endovascular embolization of branch- incorporated cerebral aneurysms [J]. Neuroradiol J, 2017, 30(6): 600-606.

[6] Yang Y, Su W, Meng Q. Endovascular treatment of ruptured true posterior communicating artery aneurysms [J]. Turk Neurosurg, 2015, 25(1): 73-77.

[7] Kim BM, Park SI, Kim DJ, et al. Endovascular coil embolization of aneurysms with a branch incorporated into the sac [J]. AJNR Am J Neuroradiol, 2010, 31(1): 145-151.