血管内支架成形术治疗颅内宽颈动脉瘤及长期随访结果

目的 探讨血管内支架结合弹簧圈治疗颅内宽颈动脉瘤的长期疗效及安全性。方法 对65例采用血管内支架结合弹簧圈栓塞技术治疗的颅内宽颈动脉瘤患者进行定期的脑血管造影及临床随访，比较其影像学特征变化。结果所有患者均成功植入支架，影像学随访18-45个月(平均24．7个月)，42例致密栓塞的患者中，无一例动脉瘤复发；23例部分栓塞的患者中，18例进一步血栓形成，瘤内无造影剂显影，4例结果稳定，1例动脉瘤复发而再次治疗。临床随访中无一例发生再出血或血栓栓塞症状。结论血管内支架植入后可改变动脉瘤的血流动力学模式以防止动脉瘤复发，并通过促进瘤颈内膜形成达到解剖治愈。

Endovascular stenting combined with coiling for the treatment of intracranial wide - necked aneurysns: Long - term follow - up

Objective The purpose of this study was to evaluate the long-term efficacy and safety of endovascular stenting combined with coiling for intracranial wide-necked aneurysms. Methods Sixty-five patients with intracranial wide-necked aneurysms treated with combined stenting and further coiling technique were included in this retrospective study. And all the patients underwent clinical and angiographic follow-up after initial treatment. Results The stents were deployed in all patients.Follow-up angiogram for 18-45 months (24.7 months) showed that no contrast filling in 61 patients, including complete obliteration in 42 cases and aneurysm residue with further thrombosis in 19 cases, residual aneurysms with stable results in 3 patients and recanalization in one case which need another occlusion. No rebleeding or thromboembolic event occurred in clinical follow-up. Conclusions Endovascular stent changes flow characteristics and facilitate thrombosis inside the aneurysm pouch. The aneurysms can be anatomically cured by promoting endothelization at aneurysmal neck.