LVIS支架辅助栓塞颈内动脉床突上段破裂夹层动脉瘤

目的 探讨LVIS支架辅助栓塞治疗颈内动脉床突上段破裂夹层动脉瘤的可行性、有效性。方法 回顾性分析2015年6月到2018年3月采用LVIS支架辅助栓塞治疗的9例颈内动脉床突上段破裂夹层动脉瘤的临床资料。结果 9例均成功实施LVIS支架辅助栓塞治疗，术后即刻造影显示Raymond分级Ⅰ级5例，Ⅱ级4例。术后DSA随访1周~24个月，2例双LVIS支架辅助栓塞术后2周DSA复查显示动脉瘤复发，血栓弹力图示ADP>90%，调整抗血小板方案后半年后复查动脉瘤未显影；其余病人动脉瘤均未显影，载瘤动脉通畅。出院时改良Rankin量表（mRS）评分0分5例，3分2例，4分1例，6分1例；术后90 d mRS评分0分6例，1分1例，3分1例。结论 LVIS支架辅助栓塞颈内动脉床突段破裂夹层动脉瘤是一种安全、有效的方法，调整抗血小板方案可提高术后复发动脉瘤的闭塞率

LVIS stent assisted coils embolization for ruptured dissecting aneurysms in the internal carotid artery supraclinoid segment

Objective To explore the feasibility and effectiveness of LVIS stent assisted coils embolization for the dissecting aneurysms in the internal carotid artery supraclinoid segment. Methods The clinical data of 9 patients with dissecting aneurysms in in the internal carotid artery supraclinoid segment who were treated by LVIS stent assisted coils embolization from June, 2015 to March, 2018, were analyzed retrospectively. Results These 9 patients were successfully treated with LVIS stent assisted coils embolization. DSA immediately after the embolization showed Raymond grade Ⅰ in 5 patients, and grade Ⅱ in 4. The follow-up of DSA ranging from 1 weeks to 24 months after the operation showed that the aneurysms recurred in 2 patients who were treated by double LVIS stent-assisted embolization 2 weeks after the operation, and the aneurysms were disapperaed 6 months after adjusting the antiplatelet regimen. On the discharge, the modified Rankin scale (mRS) scores were 0 point in 5 patients, 3 points in 2, 4 points in 1, and 6 points in 1. Ninty days after the operation, the mRS scores were 0 point in 6 patients, 1 point in 1 and 3 points in 1. Conclusions LVIS stent assisted coils embolization is a safe and effective method for the treatment of ruptured dissecting aneurysm in the internal carotid artery supraclinoid segment. The occlusive rate of recurrent aneurysms can be increased by adjusting antiplatelet regimen