瘤颈再塑形技术在颅内宽颈动脉瘤血管内治疗中的应用

目的探讨运用瘤颈再塑形技术治疗颅内宽颈动脉瘤的适应证、技术要点、安全性及临床应用前景。方法对23例不同部位的宽颈动脉瘤运用瘤颈再塑形技术治疗，其中14例采用neuroform支架置入瘤颈再塑形结合电解可脱弹簧圈栓塞，9例采用球囊辅助瘤颈再塑形结合电解可脱弹簧圈栓塞。术后6、12个月常规复查脑血管造影，并用改良Rankin量表进行预后评价。结果23例患者的颅内动脉瘤均成功栓塞，其中100％致密栓塞15例，95％栓塞6例，90％栓塞2例；治疗后1年时生活不能自理或死亡者占17.3％；未发现动脉瘤再破裂出血者。结论应用血管内自膨式支架neuroform置入及球囊辅助瘤颈再塑形技术结合电解可脱弹簧圈栓塞是治疗宽颈动脉瘤的有效方法，有较好的临床应用前景。

Application of "remodeling technique" in endovascular treatment of intracranial wide-necked aneurysm

Objective To assess the indications, procedure, safety and application of of “remodeling technique” in treatment of intracranial wide-necked aneurysm. Methods Among 23 cases of wide-necked aneurysm, 14 were treated by neuroform stent assisted with guglielmi detached coils, and other 9 were treated by balloon assisted coiling. After six and twelve months, results were assessed by brain angiography and upgraded Rankin measuring scale. Results Intracranial aneurysms in 23 patients were successfully blocked; complete occlusion was obtained in 15 cases, 95% in 6 cases, 90% in 2 cases. The rate of disability and death was 17.3% one year after treatment and there is no recurrence. Conclusion “Remodeling technique” is an effective method for intracranial wide-necked aneurysms, and it has good clinical prospect.