血流导向装置治疗复发性颅内动脉瘤的初步经验

目的初步探讨血流导向装置治疗颅内复发动脉瘤的应用价值。方法回顾性分析3例行密网支架治疗复发颅内动脉瘤的病例资料。结果1例先前行单纯弹簧圈填塞,2例先前行支架辅助弹簧圈治疗。术前mRS评分分别为0分、2分、1分。使用PED联合弹簧圈1例,单纯PED置入2例。术后即刻造影均显示瘤腔内对比剂明显滞留。无围手术期并发症发生。出院当日mRS评分分别为0分、2分、0分。术后影像学随访1例显示动脉瘤完全闭塞。结论血流导向装置治疗选择的复发颅内动脉瘤安全有效,需严格选择适应证并制定个体化治疗策略。

Preliminary experience of flow diverter for the treatment of recurrent intracranial aneurysms

Objective To preliminarly investigate the application value of flow deverter in the endovascular treatment of recurrent intracranial aneurysm.Methods Rtrospective analysis of 3 cases of recurrent intracranial aneurysm treated with flow deverter.Results Among the 3 patients,1 was male and 2 were female,aged 55,67 and 32,respectively.There were 1 case in internal carotid artery ophthalmic artery segment,1case in internal carotid artery posterior communicating segment and 1 case in basilar artery segment.All were previously ruptured aneurysms,including 2 cystic aneurysms and 1 dissected aneurysm.One case was previously treated with simple coiling,while two cases were previously treated with stent-assisted coiling.Preoperative mRS scores were 0,2 and 1,respectively.PED combined with coil was used in 1 case,and PED alone was inserted in 2 cases.Immediate postoperative radiography showed obvious retention of contrast agent in aneurysmal sac.No perioperative complications occurred.MRS scores on discharge day were 0,2 and 0,respectively.Angiography follow-up revealed complete occlusion in 1 case.Conclusion Selected cases of recurrent intracranial aneurysm treated with PED implantation is relatively safe and effective,but strictly selecting the indications and developing the individualized treatment strategies are needed.