Health

Nghe An General Hospital performs effective flow diversion stent placement for patients with cerebral aneurysms

Thanh Chung DNUM_ADZAGZCACE 12:27

Flow diversion stent placement is an advanced endovascular intervention technique, effective treatment for cerebral aneurysms, bringing many benefits to patients, and has been successfully applied by Nghe An General Hospital.

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The team performed vascular intervention for the patient. Photo: National Hospital of Tropical Diseases

Cerebral aneurysm is a phenomenon in which the vessel wall is bulging, which can have shapes such as a sac or a diamond. This is a dangerous disease. If the aneurysm is large, it can compress the brain parenchyma, cranial nerves and cause neurological deficits. It is especially dangerous when the aneurysm ruptures, causing subarachnoid hemorrhage, cerebral hemorrhage, and even life-threatening.

Recently, the Stroke Center - Nghe An General Hospital received patient LTN, 63 years old, with a history of high blood pressure, left internal carotid artery aneurysm that was discovered at another medical facility but had not yet received any treatment. This time the patient was admitted to the hospital due to headache, dizziness, and severe fatigue.

The patient was examined, had all paraclinical tests done, had a 64-slice brain CT scan, diagnosed with unruptured left internal carotid artery aneurysm/ Hypertension/ Monitoring of blood clotting disorders.

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Doctors perform a stent placement to divert flow for a patient. Photo: BVHDKNA

On May 16, 2024, the patient underwent digital subtraction cerebral angiography, which detected a wide-necked cerebral aneurysm. The doctors consulted and selected the optimal treatment method for the patient, which was to place a flow-diverting stent. Before the intervention, the patient was given antiplatelet drugs to reduce the risk of thrombosis during the intervention.

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Image of the patient's unruptured left internal carotid artery aneurysm on X-ray. Photo: National Hospital of Internal Carotid Artery

On May 22, 2024, the patient underwent a stent diversion intervention. The intervention team released a stent into the artery carrying the aneurysm. After releasing the stent, it expanded well and the aneurysm retained contrast - a sign that the stent was effective: the flow in the artery into the aneurysm was significantly reduced and over time the aneurysm would slowly block. The intervention for the patient took 60 minutes, of which the stent release only took 10 minutes.

After the intervention, the patient was completely normal, leaving no complications for the patient... After 1 week of monitoring, treatment and close care after the intervention, the patient's health was stable and he was discharged from the hospital.

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Image after stent placement (green arrow) and image of drug accumulation in the aneurysm (pink arrow). Photo: BVHNĐKNA

The flow-diverting stent technique has been implemented and mastered by the hospital since 2018, and has so far intervened in about 20 patients. The team involved in the procedure are doctors with postgraduate qualifications, trained in intervention at major hospitals such as Bach Mai Hospital, People's Hospital 115 (Ho Chi Minh City), and Central Military Hospital 108.

The method of placing a stent to divert the flow is applied to actively treat aneurysms, limiting the possibility of aneurysm rupture causing brain hemorrhage, causing death to the patient; treating complex aneurysms that are difficult to handle by other methods such as aneurysm clipping surgery or imaging and embolization of cerebral aneurysms with metal coils. In particular, compared to clipping surgery, because it is less invasive, there is no need to open the skull, the access is only a few millimeters at the artery puncture site, blood loss is very little, if there are no complications, the patient can return to normal activities 8 hours after the intervention.

Flow diversion stenting is an effective and safe treatment method for cerebral aneurysms, bringing many benefits to patients, reducing treatment and living costs for patients when having to be treated at higher levels./.

Thanh Chung